Bentall手术和分叉支架植入术治疗Stanford A型夹层动脉瘤  

Stanford A type aortic dissecting aneurysm treated with Bentall operation and bifurcation stent implantation

作　　者：姚俊红[1] 陈劲进[2] 孙国林[1,2] 肖颖彬[2] 

机构地区：[1]蚌埠市第一人民医院心胸外科,安徽蚌埠233000 [2]第三军医大学新桥医院心血管外科,重庆400038

出　　处：《局解手术学杂志》2014年第4期385-387,共3页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的 总结应用Bentall手术和分叉支架植入术（杂交手术）治疗Stanford A型夹层动脉瘤结果.方法 Stanford A型夹层动脉瘤患者40例,其中男32例,女8例,年龄范围为25 ～ 75岁,平均（43.8±14.7）岁.其中28例在深低温停循环下行杂交手术,12例在中低温体外循环下行Bentall手术.应用SPSS 13.0统计软件分析杂交手术组和Bentall手术组、死亡组与存活组手术前后肝肾功能、心肌酶变化.结果 40例主动脉瘤患者中治愈出院的为36例,治愈出院率为90％.死亡4例,总死亡率为10％.存活患者无截瘫及脑中风发生.杂交手术组和Bentall手术组肝肾功能、心肌酶指标均无显著性差异.死亡组与存活组比较,患者术后肝肾功能、心肌酶多项指标有显著性差异.结论 深低温停循环下行Bentall手术和分叉支架植入术治疗Stanford A型夹层动脉瘤安全有效;体外循环中注意保护肝脏功能可以进一步提高生存率.Objective To summarize the operation consults of Stanford A type aortic dissecting aneurysm treated with Bentall operation and bifurcation stent implantation （hybrid operation）. Methods There were 40 patients with Stanford A type aortic dissecting aneurysm,of whom 32 were male,8 were female,age ranged 25 ～75 year-old,mean （43.8 ± 14.7） year-old. 28 patients had hybrid operation with deep hypothermia and circulation arrest, 12 had Bentall operation with medium hypothermia. The hepatic and renal function and myocardial enzyme before and after operation between the group of Hybrid operation and that of Bentall operation, and between the survival group and dead group were analyzed by SPSS13.0 statistical soft. Results 36 patients（ 90% ） cured without paralysis and brain stroke,4 patients （ 10% ） were dead. There was no significant difference in the hepatic and renal function and myocardial enzyme before and after operation between the group of hybrid operation and that of Bentall operation, but there was significant difference between the survival group and dead group after operation, Conclusion The hybrid operation is safe and effective, which can improve the survival rate by protecting the hepatic and renal function during cardiopulmonary bypass.

关 键 词：STANFORD A型夹层动脉瘤 分叉支架植入术 BENTALL手术 杂交手术 

分 类 号：R654.1[医药卫生—外科学] R543.16[医药卫生—临床医学]