急性主动脉夹层动脉瘤行全弓置换术后并发症的处理  

Measures of complications in patients with acuteaorticdissection

作　　者：吴洪江[1] 李俊[1] 王辉山[1] 陈燕[1] 方敏华[1] 张宏家[2] 

机构地区：[1]沈阳军区总医院心血管外科,辽宁沈阳110840 [2]首都医科大学附属北京安贞医院心脏外科,北京100029

出　　处：《中国医药导报》2012年第33期59-60,64,共3页China Medical Herald

基　　金：国家自然科学基金(项目编号:81170283)

摘　　要：目的探讨急性主动脉夹层动脉瘤行全弓置换术后并发症的处理。方法选择沈阳军区总医院2009年2月~2011年2月收治的100例急性主动脉夹层动脉瘤患者,随机分为对照组和观察组,各50例,对照组对患者仅采取常规治疗;观察组对患者采取全弓置换术进行治疗,并对并发症进行有效防治;治疗工作的重点是及时缓解患者的心理压力,预防及减少并发症。结果治疗后,观察组患者的汉密尔顿抑郁量表（HAMD）和汉密顿焦虑量表（HAMA）值明显低于对照组,差异有统计意义（P〈0.05）;观察组患者术后出血的发生率为2%,急性肾功能损伤的发生率为4%,高血压的发生率为10%,神经系统功能障碍的发生率为6%,死亡率为8%,均明显低于对照组,差异均有统计学意义（均P〈0.05）。结论对急性主动脉夹层动脉瘤行全弓置换术后并发症进行有效治疗,可以明显提高治疗质量,值得推广应用。Objective To discuss the intervention on the complications in the patient with acute aortic dissection.Methods 100 cases with fracture of neck of femur in our hospital from February 2009 to February 2011 were chose,they were randomly divided into the control group and the observation group,the control group was given the conventional methods,while the observation group was given the total aortic arch replacement,and complications were prevented.Highlight of the work was to relief the mental pressure,to prevent and reduce the occurrence of complications.Results After the treatment,HAMD scores,HAMA scores of observation group were significantly lower than those of the control group,there were statistically significant differences between the two groups（P 0.05）.The patients in the observation group of postoperative bleeding occurred in 2%,acute renal injury incidence was 4%,the incidence of hypertension in 10%,nervous system dysfunction occurring rate was 6%,the mortality rate was 8%,significantly lower than in the control group,the difference was statistically significant（P 0.05）.Conclusion Treat the patients with acute aortic dissection in total arch replacement postoperative complications effectivly can significantly improve the treatment quality,and it should be widely applied in clinical.

关 键 词：急性主动脉夹层动脉瘤 全弓置换 并发症 

分 类 号：R543.1[医药卫生—心血管疾病]