“一站式”Hybrid技术治疗复杂主动脉疾病的临床研究  

A study on “one-stop”hybrid technique in the treatment of complicated aortic diseases

作　　者：贺行巍[1] 曾和松[1] 李柱锡 严江涛[1] 周强[1] 蒋建刚[1] 郭小梅[1] 马业新[1] 魏翔[1] 徐利军[1] 刘立刚[1] 胡敏[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院心脏中心,湖北武汉430030

出　　处：《中国介入心脏病学杂志》2015年第8期433-435,共3页Chinese Journal of Interventional Cardiology

摘　　要：目的探索"一站式"Hybrid技术治疗复杂主动脉疾病的方法和临床疗效。方法纳入2012年7月至2014年12月于华中科技大学同济医学院附属同济医院采用"一站式"Hybrid手术治疗复杂主动脉疾病患者共33例,其中男31例,平均年龄(51.3±11.5)岁。33例患者中A型夹层4例、B型夹层累及主动脉弓部27例及主动脉弓瘤2例。A型夹层采取非深低温体外循环下行升主动脉置换+人工血管旁路移植术,其余患者均在全麻下行人工血管旁路移植术,之后所有患者均经股动脉入径数字减影血管造影(DSA)下行主动脉覆膜支架置入术。结果所有患者手术均成功,围术期因感染性休克死亡1例,其余均无偏瘫、截瘫、脑肺功能障碍、凝血障碍及严重感染等严重并发症发生且痊愈出院。术后平均随访13.5(3.7,24.7)个月,所有患者均存活,无严重并发症发生。1年后复查主动脉CT血管造影显示旁路人工血管及支架血流均通畅,支架无移位和内漏。结论 "一站式"Hybrid技术治疗复杂主动脉疾病,在简化手术复杂程度的同时也降低了死亡率和并发症发生率,具有较好的近期临床疗效,远期疗效有待于进一步观察。Objective To evaluate the methods and clinical effects of the ＂one stop＂hybrid technique for complicated aortic diseases. Methods From July 2012 to December 2014,33 consecutive patients with complicated aortic diseases in Tongji Hospital received treatment with hybrid technique.Strategies for Stanford type A aortic dissection（ AD） included ascending aortic replacement and surgical reconstruction of the supra-aortic branches. Strategy for type B-AD and aortic arch aneurysm was only surgical reconstruction of the supra-aortic branches. Endovascular stent-graft placement was performed synchronously thereafter. Results All patients were successfully operated without any serious complications and only one patient died from septic shock in peri-operative period. The patients were followed up for 13. 5（ 3. 7,24. 7） months without any death or serious complication. CT angiography was rechecked 1 year after procedure,and the results revealed that the blood flow of artificial vessel and stent-graft were patent without endoleak or stent dislocation. Conclusions ＂One stop＂hybrid technique is a safe and effective approach for treating patients with complicated aortic disease. The short-term results were favorable,but long-term follow-up is required.

关 键 词：主动脉夹层 主动脉弓瘤 “一站式”Hybrid技术 胸主动脉腔内修复术 

分 类 号：R543.1[医药卫生—心血管疾病]