40例急性A型主动脉壁内血肿的外科治疗  

The surgical outcomes of acute type A aortic intramural hematoma： a curative effect analysis of 40 cases

作　　者：史艺[1] 孙晓刚[1] 刘雁翔[1] 常谦[1] 钱向阳[1] 楚军民[1] 刘文超[1] 方方[1] 

机构地区：[1]国家心血管病中心 中国医学科学院阜外医院血管外科中心,北京100037

出　　处：《中华胸心血管外科杂志》2017年第3期168-170,共3页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：目的 评估急性A型主动脉血肿的外科临床疗效.方法 选择阜外医院2012年1月1日至2014年12月31日外科治疗急性A型血肿患者40例.男23例,女17例.术前升主动脉CTA测量值示：主动脉直径（50.3 ±10.3） mm,血肿厚度（15.9±6.4） mm.急诊手术16例（40％）,择期手术24例（60％）.手术方式包括：升主动脉及全弓置换手术12例,升主动脉及部分主动脉弓替换28例.术后随访均采用主动脉CTA检查评估疗效,持续随访2年.结果 院内死亡2例（5％）,均为急诊病例.术后住ICU（1.5±0.7）天.出院病例随访2年无死亡患者,术后CTA结果提示血肿消失,无继发主动脉夹层等严重并发症.结论 根据急性A型血肿的病变程度和部位选择不同的外科术式均能够取得良好的临床疗效。Objective The aim of this study is to evaluate clinical outcomes of patients with acute type A intranural hematoma of the aorta（IMH） received surgical treatment.Methods We analyzed 40 consecutive patients with acute type A aortic IMH in Fuwai hospital.The patients are from 2012.1.1 to 2015.12.31.The average age of patients is（56 ± 11） years.Clinical outcomes and morphological evolution by CT were analyzed for 2 years.Results Most of the patients were treated medically during their initial hospitalization.There were 2 patients died in in-hospital and no 2-year mortality.16 patients （40%） were received acute surgery,24 patients（60%）were received normal surgery.Conclusion Surgical treatment would be a favorable treatment option in type A acute IMH.

关 键 词：主动脉壁内血肿 外科治疗 临床疗效 

分 类 号：R654.3[医药卫生—外科学]