胸主动脉夹层术后监护与治疗  

Postoperative care and treatment of thoracic aortic dissection

作　　者：柳亚奎[1] 王志维[1] 胡小平[1] 周桢[1] 李罗成[1] 邓宏平[1] 徐鹏[1] 

机构地区：[1]武汉大学人民医院心血管外科,430060

出　　处：《临床外科杂志》2012年第2期120-122,共3页Journal of Clinical Surgery

基　　金：湖北省自然科学基金资助项目（2008CHB421）

摘　　要：目的 总结胸主动脉夹层术后监护与治疗的临床经验.方法 134例行胸主动脉夹层手术患者,术后入重症监护室（ICU）进行系统监护.根据患者的各系统状况和主动脉夹层特点,给予相应的支持对症治疗,尽早积极有效地防治可能出现的并发症.结果 平均ICU停留时间（78±53）h;术后死亡5例;一过性脑功能紊乱19例,延迟苏醒1例,脑血管意外3例,截瘫1例;低氧血症31例;心肌缺血1例,室性心律失常2例;术后肾功能衰竭1例;血管吻合口出血二次开胸止血4例;术后感染3例.结论 术后加强各系统的监护,尽早对高危因素分析与评估,有效预防、积极处理各系统并发症,是胸主动脉夹层患者顺利康复的保障.Objective To summarize our clinical experience about postoperative care and treatment of thoracic aortic dissection （TAD）. Methods From August 2009 to April 2011,134 TAD patients accepted surgical treatment in our department. All the patients stayed in intensive care unit（ICU） after operation. Patients with different physical status and dissection characteristics were treated individually to prevent any possible complication. Results The average length of ICU stay was 78 ± 53 hours. Five patients died during hospitalization. Postoperative hypoxemia occurred in 31 patients,transient cerebral dysfunction in 19, cerebrovascular accident in 3, infection in 3, ventricular arrhythmias in 2 ; Paraplegia, delayed awaken, renal failure and myocardial ischemia occurred in 1 patient respectively; 4 cases accepted re - operation to stanch. Conclusion Intensive care of each organ, timely assessment of high risk factors, and active prevention and treatment of possible complications are important factors contributing to TAD patients＂ recovery.

关 键 词：胸主动脉夹层 并发症 术后监护 治疗 

分 类 号：R654.3[医药卫生—外科学]