StanfordB型主动脉夹层腹膜支架术后的程序化重症监护治疗  

Protocolized management in intensive care unit for post-interventional Stanford B aortic dissection patients

作　　者：沈晔[1] 张美齐[1] 韩楠楠[1] 陈环[1] 方玲翠[1] 蔡文伟[1] 

机构地区：[1]浙江省人民医院杭州医学院附属人民医院急诊医学科,杭州310014

出　　处：《中华重症医学电子杂志》2017年第4期271-274,共4页Chinese Journal Of Critical Care & Intensive Care Medicine(Electronic Edition)

摘　　要：目的探讨程序化重症监护策略对腹膜支架治疗Stanford B型主动脉夹层术后的缺血再灌注器官功能疗效的维护。方法回顾性分析2012年2月至2017年2月61例Stanford B型主动脉夹层的临床资料。61例患者均采用覆膜支架植入术。分别经过肺保护通气、循环管理、器官功能保护、抗感染等程序化重症监护治疗,评估术后呼吸、肾功能、及术后康复情况。结果 2例患者死于多脏器衰竭,其余患者术后均成功拔除呼吸机,大部分已康复出院。结论 Stanford B型主动脉夹层患者经有效的维护缺血再灌注器官及肺保护通气策略能有效提高治愈率。ObjectiveTo investigate the effect of protocolized management in intensive care unit for patients with Stanford type B aortic dissection （AD） undergoing thoracic endovascular aortic repair （TEVAR）. Methods We retrospectively analyzed clinical data from February 2012 to February 2017. All 61 patients with Stanford type B AD patients undergoing TEVAR accepted the following care principles lung protective ventilation, hemodynamic support, organ function protection and anti-infection therapy. Postoperative function of respiratory system and kidney, and rehabilitation were compared. ResultsTwo patients died of multiple organ failure. The rest were successfully extubated and most of them were discharged after rehabilitation. ConclusionFor post-interventional Stanford B aortic dissection patients, use of lung protective ventilation and prevention of ischemia-reperfusion injury improved the prognosis.

关 键 词：主动脉夹层 腹膜支架 重症监护 术后管理 

分 类 号：R654.3[医药卫生—外科学]