65岁以上A型主动脉夹层患者手术方式的选择及疗效  

The surgical methods and efficacy of 70 cases over 65 years old patients with aortic dissection

作　　者：冯永滔[1] 范瑞新[1] 郑少忆[1] 马少鸿[1] 范小平[1] 于长江[1] 

机构地区：[1]广东省医学科学院广东省心血管病研究所广东省人民医院心外科,广州510080

出　　处：《中华胸心血管外科杂志》2013年第12期719-721,共3页Chinese Journal of Thoracic and Cardiovascular Surgery

基　　金：基金项目：国家“十二五”科技支撑计划（2011BAI11B20）;广东省科技计划项目（2012A030400056）

摘　　要：目的总结65岁以上主动脉夹层患者手术方式的选择及疗效。方法2005年1月至2012年5月，70例65岁以上主动脉夹层患者接受手术治疗。男47例，年龄65～78岁，平均71岁；女23例，年龄65～72岁，平均68岁。急性发病期55例，慢性期15例。根据相应病情采取不同手术方式，并对术后患者进行门诊随访，了解术后病情变化及疗效。结果住院死亡8例，余均痊愈出院。随访3～72个月。随访期内无死亡，无动脉瘤破裂等严重并发症。9例术后6个月行覆膜支架腔内置入术。结论对于65岁以上主动脉夹层患者，选择确切、快捷的手术方式有助于减少术后并发症，提高患者的生存率及生活质量。Objective To retrospectively analyze the surgical methods and efficacy in 70 cases of type A aortic dissection patients over 65 years old. Methods From January 2005 to May 2012, 70 type A aortic dissection patients over 65 years old received surgical treatment. Among them, there were 47 males aged 65 to 78 years old with mean 71,23 females, aged 65 to 72 years old with mean 68. 55 cases were acute onset, while 15 cases were chronically onset. Different surgical methods were selected depend on patients＇ situations. We followed up all patients after discharged from hospital to continue to observe their health situation and evaluate the therapeutic effects. Results After surgery, eight patients died in the hospital, 62 pa- tients were recovered and discharged from the hospital. The mortality rate is 11.4%. During the follow up period from 3 to 72 months, there were no dead, aneurysm rupture and others severe complications. 9 cases received endovascular graft exclusion within 6 months after discharged from hospital. The survival patients were satisfactory healed with their daily living activity re- sumed. Conclusion For over 65 years old patients with aortic dissection, the accurate and rapid selection of surgical method could improve the survival rate and the quality of life with a lower occurrence rate of complications.

关 键 词：主动脉 夹层动脉瘤 老年 心脏外科手术 主动脉置换 

分 类 号：R654.2[医药卫生—外科学]