改良吻合技术在Bentall手术中的应用  

Application of modified anastomosis technique in Bentall surgery

作　　者：王波[1] 曹劲松 李莎[1] 符竣[1] WANG Bo;CAO Jin-song;LI Sha;FU jun(Cardiovascular Surgery,Huhan Asian Heart Hospital,Wuhan 430022,China)

机构地区：[1]武汉亚洲心脏病医院心外科,湖北省武汉市430022

出　　处：《中国心血管病研究》2020年第2期120-122,共3页Chinese Journal of Cardiovascular Research

基　　金：国际联合科研项目。

摘　　要：目的评估改良人工血管吻合技术在Bentall手术中的应用,分析并总结其临床经验.方法回顾性分析自2018年1月至2019年6月在武汉亚洲心脏病医院心脏大血管中心连续收治的48例主动脉根部病变(包括马方综合征、急性主动脉夹层)并应用改良吻合技术行Bentall手术治疗患者的临床资料.其中男性39例、女性9例;年龄(51.23±13.83)岁,其中38例单纯行Bentall手术,4例行生物瓣Bentall手术,6例同期行半弓置换术,4例行同期行二尖瓣置换,深低温停循环5例.结果进行改良Bentall手术患者的体外循环时间为(166.31±44.99)min;主动脉阻断时间为(114.38±34.43)min;机械通气时间为(16.33±7.69)h;术后重症监护病房治疗时间为(3.20±1.47)d;术后住院时间为(13.25±6.30)d.二次开胸止血1例,无围术期死亡.随访48例,随访时间1~19个月,随访结果满意.结论改良人工血管吻合技术在Bentall手术中的应用效果满意,可有效降低术中及术后出血风险,早期预后良好.Objective To analyze and summarize the clinical experience of using modified artificial vascular anastomosis in Bentall surgery.Methods Through retrospectively analysing the clinical data of 48 patients with aortic root lesions(including没arfan syndrome and acute aortic dissection)were treated with modified Bentall surgery from January 2018 to June 2019 in the center of cardiac macrovascular of wuhan Asian heart hospital.There were 39 male and 9 female.The patients were(51.23±13.83)years old.Among them,34 cases received Bentall surgery alonely,4 case received Bentall surgery with biological valve,6 cases received hemiarch replacement,4 cases received mitral valve replacement,and 5 cases received deep hypothermia and circulatory arrest.Results Patients undergoing modified Bentall surgery had a CPB time of(166.31±44.99)min.The duration of aortic occlusion was(114.38±34.43)min.Mechanical ventilation time was 16.33±7.69h.The postoperative treatment time in ICU was 3.2±1.47 days.Postoperative hospital stay was 13.25±6.3d.Secondary thoracotomy for hemostasis in 1 patient,no perioperative death.48 cases were followed up for 1-19 months with satisfactory results.Conclusion The application of modified artificial vascular anastomosis in Bentall surgery is satisfactory and can effectively reduce the risk of intraoperative and postoperative bleeding,with good short-term results.

关 键 词：人工血管吻合 BENTALL 主动脉根部瘤 

分 类 号：R654.2[医药卫生—外科学]