短支架血管在Stanford A型主动脉夹层根部手术中的应用  

The application of short stent in root of aorta for the treatment of Stanford type A aortic dissection

作　　者：陈兴澎[1] 赵勇鹏[1] 叶亚飞[1] 陈嵩[1] 朱贵军[1] 胡杰[1] Chen Xingpeng Zhao Yongpeng Ye Yafei Chen Song Zhu Guijun Hu Jie(Department of Cardiovascular Surgery, Luoyang Central Hospital Affiliated to Zhengzhou University, Luoyang 471009, China)

机构地区：[1]郑州大学附属洛阳中心医院心脏大血管外科,河南洛阳471009

出　　处：《中华医学杂志》2017年第22期1737-1739,共3页National Medical Journal of China

摘　　要：目的探讨应用短支架血管对Stanford A型主动脉夹层患者进行主动脉根部处理的疗效。方法回顾性分析2013年1月至2015年12月郑州大学附属洛阳中心医院心脏大血管外科收治的39例Stanford A型主动脉夹层患者的临床资料，其中男31例，女8例，年龄27～75岁（49．3±10．3）岁，所有患者接受升主动脉短支架血管植入十全主动脉弓置换＋降主动脉腔内隔绝术治疗。结果全组手术均顺利完成，住院死亡2例（5．1％），二次开胸探查4例（10．8％，4／37）。患者术后随访时间3～24个月，中位随访14个月，随访期间死亡1例，死亡原因为肺部感染、消化道出血及肾功能衰竭。结论短支架血管可较安全有效地应用于破口位置较高的Stanford A型主动脉夹层患者。Objective To explore the effect of implanting short stent in root of aorta for the treatment of Stanford type A aortic dissection. Methods Clinical data of 39 patients with Stanford type A aortic dissection who underwent surgical procedure at the Department of Cardiovascular Surgery of Luoyang Central Hospital Affiliated to Zhengzhou University, between January 2013 and December 2015 were retrospectively analyzed. There were 31 males and 8 females aged 27 to 75 （49. 3 ± 10. 3 ） years. All patients received short stent implanting in aortic root, total arch replacement and stented elephant trunk implantation were performed at the same time. Results All the operations were successfully performed. Two patients died during hospitalization. Four patients underwent reexploration for postoperative bleeding. Postoperative mortality was 5. 1% （2/39）. Follow-up duration was 3 to 24 months, with a median time of 14 months. One patient died of lung infection, gastrointestinal bleeding and renal faliure during follow-up. Conclusion Patients with aortic intimal tear located at higher root of aorta may be suitable for short stent implanting, and the procedure has satisfactory clinical outcomes.

关 键 词：动脉瘤 夹层 主动脉瘤 人工血管 短支架 心血管外科手术 

分 类 号：R654.3[医药卫生—外科学]