Stanford A型主动脉夹层术中脑保护策略的研究进展  

Advances in Brain Protection Strategies for Stanford Type A Aortic Dissection

作　　者：展旭 孟维鑫[1] 康凯[2] 谢宝栋 ZHAN Xu;MENG Weixin;KANG Kai;XIE Baodong(Department of Cardiovascular Surgery,the First Affiliated Hospital of Harbin Medical University,Harbin 150001,China;Department of Cardiovascular Surgery,the Second Affiliated Hospital of Harbin Medical University,Harbin 150086,China)

机构地区：[1]哈尔滨医科大学附属第一医院心外科,哈尔滨150001 [2]哈尔滨医科大学附属第二医院心外科,哈尔滨150086

出　　处：《医学综述》2020年第17期3364-3368,3374,共6页Medical Recapitulate

基　　金：国家自然科学基金(81871501);黑龙江省自然科学基金(H2018021,H2018037);黑龙江省博士后科研启动基金(LBH-Q17094)。

摘　　要：术后神经功能损伤在Stanford A型主动脉夹层患者中的发生率一直不容忽视,严重影响患者的预后和生活质量。目前认为其原因是脑血管栓塞以及术中脑保护不足。为了减少这一并发症的发生,越来越多的心脏外科医师致力于研究主动脉夹层患者术中的脑保护策略。近年来,中低温停循环联合顺行性脑灌注的脑保护策略被越来越多的中心所采用,并取得了较好的临床结果,但目前不同中心尚无统一标准,故未来仍需更多临床研究来进一步评估和完善术中脑保护策略。The incidence of postoperative neurologic deficits in patients with Stanford type A aortic dissection has long been unneglectable,which seriously affects the prognosis and living quality of the patients.At present,the common causes to the problem are attributed to the cerebral embolization and insufficient brain protection during operation.In order to reduce the complications,more and more cardiac surgeons are focused and committed to improving the patients′brain protection strategy.Recently,the strategies of moderate hypothermic circulatory arrest combined with antegrade cerebral perfusion are widely used for brain protection and have achieved satisfactory clinical results.However,there is no unified standard among different centers,therefore more clinical studies are needed to further evaluate and improve the intraoperative brain protection strategy.

关 键 词：Stanford A型主动脉夹层 脑保护 深低温停循环 顺行性脑灌注 逆行性脑灌注 

分 类 号：R654[医药卫生—外科学]