急性主动脉夹层合并下肢缺血的外科治疗效果  

Surgical treatment of aortic dissection with lower extremity ischemia

作　　者：薛金熔[1] 李滨[2] 刘永民[1] 白涛[1] 潘旭东[1] 刘宁宁[1] 曲政[1] 孙立忠[1] 

机构地区：[1]首都医科大学附属北京安贞医院心脏外科中心北京市心肺血管疾病研究所北京市大血管疾病诊疗研究中心,100029 [2]河北医科大学第三医院心脏外科

出　　处：《中华医学杂志》2017年第14期1093-1095,共3页National Medical Journal of China

摘　　要：目的探讨StanfordA型急性主动脉夹层合并下肢缺血的外科治疗效果。方法回顾性分析2009年3月至2013年4月首都医科大学附属北京安贞医院心脏外科中心14例合并下肢缺血的急性A型主动脉夹层患者资料，14例患者均接受孙氏手术治疗，并同期行升主动脉-髂动脉转流、升主动脉一股动脉转流、股动脉．股动脉转流或腋动脉一股动脉转流手术。结果术后患者死亡2例，死亡原因均为并发多器官功能障碍综合征。其余患者术后均顺利康复出院，下肢缺血症状消失或改善，术后平均随访24个月，患者无主动脉相关并发症发生。结论对于合并下肢缺血的A型主动脉夹层患者，积极行股动脉转流术，有助于降低手术死亡发生率，提高生存率和术后生活质量。Objective To explore the clinical outcome of the surgical treatment for aortic dissection with lower extremity ischemia. Methods Between March 2009 and April 2013, 14 patients with type A aortic dissection and lower extremity ischemia underwent Sun＇s procedure in Beijing Anzhen Hospital. Ascending aorta-iliac artery bypass, ascending aorta-femoral artery bypass, femoral-femoral artery bypass and axillary -femoral artery bypass were performed on some severe patients at the same time. Results Two death occurred, and the others were improved or recovered from symptoms. Follow-up was complete with an average time of 24 months and no aortic relevant complications occurred. Conclusion As for patients with type A aortic dissection and lower extremity ischemia, simuhaneous radical femoral artery bypass procedure is effective in imoroving their survival rate and auality of life.

关 键 词：动脉瘤 夹层 主动脉瘤 动脉闭塞性疾病 下肢缺血 孙氏手术 

分 类 号：R654[医药卫生—外科学]