48例急性A型主动脉夹层的外科治疗  

Surgical management for 48 patients with acute aortic dissection type A

作　　者：董圣军[1] 封赞祥[1] 李伟[1] 刘典晓[1] 王锋[1] 吴恩刚 

机构地区：[1]滨州医学院附属医院心脏外科,滨州256603

出　　处：《滨州医学院学报》2015年第2期106-108,共3页Journal of Binzhou Medical University

摘　　要：目的总结48例急性A型主动脉夹层外科治疗的临床经验。方法选取我院2009年6月至2014年6月48例急性A型主动脉夹层患者资料进行回顾性分析,这些患者行升主动脉及主动脉弓部置换加术中支架植入术,包括Bentall术28例,近端单纯升主动脉置换20例。结果住院死亡者2例(4.16%),其中1例术中心功能较差,无法撤离体外循环而死亡;另1例术后长期昏迷,其家属放弃治疗而自动出院。偏瘫者1例、一过性肾功能不全者3例、声音嘶哑者5例、胸部切口感染者2例、处理后恢复良好。46例出院前复查主动脉CTA见升主动脉及主动脉弓部人工血管无扭曲、血流通畅,无假性动脉瘤形成。随访43例患者术后1、6月、1年复查见降主动脉假腔闭合率约80%,降主动脉及腹主动脉扩张者3例,腹主动脉假性动脉瘤者1例,无死亡及再次手术者。结论手术治疗急性A型主动脉夹层更为有效、安全。Objective To review the experience of surgical treatment of 48 patients with acute aortic dissection type A .Meth‐ods We retrospectively analyzed the clinical data of forty‐eight patients with acute aortic dissection type A that underwent as‐cending aorta and total aortic arch replacement combined with transaortic stented graft implantation into the descending aorta , including Bentall procedure in 28 cases ,graft replacement of ascending aorta in 20 cases .Results The in‐hospital mortality was 4 .16% ,and 43 patients（89.58% ） were followed up for 12 months ,during which no case of death and reoperation was found . Conclusion Surgical management for acute aortic dissection type A has an excellent effect .

关 键 词：急性主动脉夹层 手术治疗 人工血管 

分 类 号：R654.3[医药卫生—外科学]