可调式单分支覆膜支架血管在Stanford A型主动脉夹层手术应用的远期疗效  

Long period outcomes of surgical treatment of Stanford type A aortic dissection by using adjustable single branch covered stent

作　　者：李欣[1] 范瑞新[1] 于长江[1] 张洪宇[1] 范小平[1] 简旭华[1] LI Xin FAN Rui-xin YU Chang-jiang ZHANG Hong-yu FANG Xiao-pin JIAN Xu-hua(Cardiac Pediatrics Department, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510100, China)

机构地区：[1]广东省心血管病研究所心外科广东省人民医院(广东省医学科学院),广州510100

出　　处：《岭南心血管病杂志》2017年第3期289-293,共5页South China Journal of Cardiovascular Diseases

基　　金：广东省省级科技计划项目(项目编号:2015A020214017);广州市科技计划项目(项目编号:2014Y2-00052)

摘　　要：目的探讨Stanford A型主动脉夹层外科手术中使用可调式单分支覆膜支架血管的可行性及远期疗效。方法将2014年8月到2015年4月广东省人民医院心外科收治的Stanford A型主动脉夹层患者按照知情同意,入选、排除标准原则,抽签决定主动脉弓部处理方法,分为应用可调式单分支覆膜支架(A)组和应用常规支架血管(B)组,分别行升主动脉/bentall+全主动脉弓置换+支架象鼻支架手术。结果入组患者共27例,A组18例和B组9例,两组病死率比较,差异无统计学意义(A组死亡1例,B组死亡2例,P>0.05)。两组年龄、体质量、手术时机、体外循环时间、阻断时间、手术时间、手术出血量、手术后24 h引流量、重症监护病房停留时间、呼吸机时间和并发症发生率等比较,差异均无统计学意义(P>0.05)。结论可调式单分支覆膜支架简化手术步骤,降低手术难度的同时,达到了与常规手术治疗Stanford A型主动脉夹层相近的临床疗效,单分支覆膜支架可用于主动脉支架象鼻手术治疗主动脉A型夹层。Objectives To discuss the feasibility and long period outcomes of Stanford type A aortic dissection byusing adjustable single branch covered stent. Methods From August 2014 to April 2015,basing on inclusion andexclusion criteria,patients with Stanford type A aortic dissection were divided in using adjustable single branch coveredstent（A）group and traditional stent（B）group randomly after agreed and signed informed consent,and then underwentascending aorta replacement/Bentall ＋ arch aorta replacement ＋ stented elephant trunk implantation operation usingdifferent aortic graft. Results There were 18 patients in A group and 9 patients in B group. There was no difference inmortality between the two groups（1 patient died in group A,2 patients died in group B,P〈0.05）. There were nodifferences in preoperative status,operation timing,bypass duration,cross-clamp duration,operation duration,intraoperative bleeding volume,drainage volume in 24 h postoperation,intensive care unit（ICU）stay,mechanicalventilation duration and complications between the two groups（P〉0.05）. Conclusions The adjustable single branchcovered stent simplifies the operation and has the similar outcomes compared with traditional way.

关 键 词：主动脉夹层 外科手术 单分支覆膜支架 术中支架 左锁骨下动脉 

分 类 号：R543.16[医药卫生—心血管疾病]