自制人工血管预缝合心包片在Stanford A型主动脉夹层中的疗效分析  

Effect of self made artificial blood vessel pre-sewed and wrapped the pericardium on the treatment of Stanford type A aortic dissection

作　　者：左逸 程光存 葛建军 Zuo Yi;Cheng Guangcun;Ge Jianjun(Department of Cardiovascular Surgery,the First Affiliated Hospital of University of Science and Technology of China,Anhui Provincial Hospital,Hefei 230000,China)

机构地区：[1]中国科学技术大学附属第一医院(安徽省立医院)心脏大血管外科,合肥230000

出　　处：《中国医师进修杂志》2020年第7期634-639,共6页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨自制人工血管预缝合心包片行右心房内引流技术在Stanford A型主动脉夹层中的疗效。方法回顾性分析2016年12月至2019年10月中国科学技术大学附属第一医院60例行孙氏手术的Stanford A型主动脉夹层患者的临床资料。其中,采用直接包裹人工血管行内引流26例(A组),采用自制人工血管预缝合心包片行内引流34例(B组)。比较两组术中和术后情况。结果手术均顺利完成。B组体外循环时间、术中红细胞用量、术中血浆用量和术后24 h引流量明显少于A组[(174.09±12.11)min比(225.23±20.40)min、(5.56±1.16)U比(10.50±2.25)U、(650.00±137.62)ml比(953.85±221.33)ml和(515.59±89.16)ml比(667.88±76.55)ml],差异有统计学意义(P<0.01);两组主动脉阻断时间、深低温停循环时间、呼吸机使用时间、住院时间、并发症发生率和病死率比较差异无统计学意义(P>0.05)。结论Stanford A型主动脉夹层患者采用自制人工血管预缝合心包片行孙氏手术的方法使手术操作简化,进一步优化了内引流技术,利于减少术中出血量和用血量,缩短体外循环时间,效果确切。Objective To explore the efficacy of right atrium drainage method in Stanford A aortic dissection by using self made artificial blood vessel pre-sewed and wrapped the pericardium.Methods The clinical data of 60 Stanford type A aortic dissection patients undergoing Sun′s surgery in the First Affiliated Hospital of University of Science and Technology of China from December 2016 to October 2019 were retrospectively analyzed.Among them,26 patients were treated with directly wrapped artificial blood vessels for right atrial drainage(group A),and 34 patients were treated with self made artificial blood vessel pre-sewed and wrapped the pericardium(group B).The intraoperative and postoperative conditions were compared between 2 groups.Results All operations were completed successfully.The extracorporeal circulation time,intraoperative red blood cell dosage,intraoperative plasma dosage and 24 h postoperative drainage volume in group B were significantly lower than those in group A:(174.09±12.11)min vs.(225.23±20.40)min,(5.56±1.16)U vs.(10.50±2.25)U,(650.00±137.62)ml vs.(953.85±221.33)ml and(515.59±89.16)ml vs.(667.88±76.55)ml,and there were statistical differences(P<0.01);there were no statistical differences in aortic cross-clamping time,deep hypothermic circulatory arrest time,ventilation time,hospital stay,morbidity and mortality between 2 groups(P>0.05).Conclusions Self made artificial blood vessel pre-sewed and wrapped the pericardium is used to perform Sun′s operation in Stanford type A aortic dissection patients,which simplifies the operation and further optimizes the internal drainage technology and is beneficial to reduce the intraoperative blood loss and blood consumption and reduce the extracorporeal circulation time,and the effect is accurate.

关 键 词：动脉瘤 夹层 人工血管 引流术 回顾性研究 

分 类 号：R654.3[医药卫生—外科学]