改良Cabrol分流在主动脉夹层手术后的疗效  

Clinical Effect of Modified Cabrol Shunt in Replacement of Ascending Aortic Graft

作　　者：刘兴光[1] 尤涛[1] 刘金成[2] 王新宽[1] 李永顺[1] 侯小东[1] 杨丽梅[1] 易康[1] 

机构地区：[1]甘肃省人民医院心外科,甘肃兰州730000 [2]第四军医大学西京医院心外科,陕西西安710038

出　　处：《现代生物医学进展》2011年第13期2490-2492,共3页Progress in Modern Biomedicine

摘　　要：目的:探讨改良Cabrol分流在升主动脉人工血管置换中的临床疗效。方法:收集2002年9月至2009年12月升主动脉人工血管置换术共72例,其中行改良Cabrol分流为39例(GroupⅠ)、瘤壁包裹人工血管不分流和完全剔除瘤壁不分流为31例为31例(GroupⅡ)。计算两组术后24h、48h的心包纵隔引流量并进行统计学分析,并对Cabrol分流的病人在术后1周和3月行心脏超声心动图检查了解是否有分流存在。结果:术后24h、48h心包纵隔引流量引流量GroupⅠ<GroupⅡ,差异有统计学意义。Cabrol分流的病人在术后1周行心脏超声心动图检查有2例存在分流信号,术后3月复查分流消失。结论:改良Cabrol分流在升主动脉人工血管置换术中能显著降低术后出血量,对注射鱼精蛋白后吻合口仍有明显渗血的病例在术中应预防性采取分流术,无相关并发症发生,可取得满意的止血效果,远期效果尚待观察。Objective： To evaluate the clinical effect of modified Cabrol shunt. Methods： Collect seventy-two patients undergoing the replacement of ascending aortic graft during September 2002 to December 2009. Calculate pericardium-mediastina drainage volume of patients underwent modified Cabrol shunt/fistula technique （GroupⅠ ）, inclusion/wrap technique and button open technique （Group Ⅱ）, postoperative twenty-four hours and forty-eighty hours, carry out statistics analysis. The patients of Group Ⅰwas checked by echocardiography to explore shunts postoperative one week and three months. Results： There were two operative deaths resulted from refractoriness ventricular chill, two patients was re-opened thoracic cavity for homeostasis. Between groups Ⅰand Ⅱ, a significant difference was found in postoperative bleeding. Analysis showed that the drainage Group Ⅰ〈Group Ⅱ. The patients performed modified Cabrol shunt were examed by echocardiography postoperative one week and three months respectively, of two patients proved shunt at one week but then disappeared at three months. Conclusion： The modified Cabrol shunt in the replacement of ascending aortic graft can cut down the postoperative haemorrhage notably, for those cases of anastomosis errhysis after injected Protamin shouled be performed prophylactic shunt, it proved gained satisfactory hemostasis without correlated complacations,then long-term effect still to wait for oberservation.

关 键 词：升主动脉人工血管置换 出血\止血 改良Cabrol分流 

分 类 号：R654[医药卫生—外科学]