单一胸骨上段小切口浅低温下行Stanford A型主动脉夹层主动脉弓置换术  

Aortic arch surgery under mild hypothermic for Standford type A aortic dissection via single upper hemisternotomy approach

作　　者：姜辉 刘宇 杨忠路 葛玉光 都业君 唐卓 王辉山[1] Jiang Hui;Liu Yu;Yang Zhonglu;Ge Yuguang;Du Yejun;Tang Zhuo;Wang Huishan(Department of Cardiovascular Surgery,General hospital of Northen Theater Command,Shenyang 110016,China;Graduate School ofChina Medical University,Shenyang 110122,China)

机构地区：[1]北部战区总医院心血管外科,沈阳110016 [2]中国医科大学研究生院,沈阳110122

出　　处：《中华胸心血管外科杂志》2021年第2期72-74,共3页Chinese Journal of Thoracic and Cardiovascular Surgery

基　　金：2020年辽宁省重点研发计划联合计划(2020JH2/10300161);辽宁省医学科技转化专项(2018225123)。

摘　　要：目的:探讨采用单一胸骨上段小切口在浅低温下行Stanford A型主动脉夹层全主动脉弓置换术的可行性与安全性。方法:2019年1月至2019年7月共35例确诊为Stanford A型主动脉夹层患者,其中男31例,女4例;年龄(43.7±5.7)岁。经单一胸骨上段小切口在浅低温下行全主动脉弓置换术并记录围手术期死亡比例、体外循环时间、主动脉阻断时间、停循环时间和神经系统并发症发病率等。结果:全组患者均在单一胸骨上段小切口浅低温下完成手术,围手术期死亡3例(8.6%);体外循环(202±53)min,主动脉阻断(128±28)min,停循环(8±3)min。短暂神经功能障碍6例(17.1%),永久性神经功能障碍1例(2.9%)。结论:单一胸骨上段小切口浅低温下行Stanford A型夹层主动脉弓置换术安全、可行。Objective To evaluate the feasibility and safety of total aortic arch surgery under mild hypothermicvia single upper hemisternotomy approach.Methods From January 2019 to July 2019,35 patients(31 male and 4 female)with Stanford A type aortic dissection were diagnosed,who were(43.7±5.7)years old.Aortic arch surgeries were carried out under mild hypothermic via single upper hemisternotomy approach and the perioperative mortality,time of cardiopulmonary bypass(CPB),aortic cross clamp(ACC),circulation arrest(CA)and morbidity of neurological dysfunction were respectively were recorded.Results All patients were finished aortic arch surgery under mild hypothermic single upper hemisternotomy approach,with 8.6%of mortality(3 patients died perioperation).The time of CPB,ACC and CA were respectively(202±53)min,(128±28)min and(8±3)min.There were 6 cases of transient neurological dysfunction(17.1%)and 1 case of permanent neurological dysfunction(2.9%).Conclusion Aortic arch surgery under mild hypothermic for Standford A dissectionvia single upper hemisternotomy approach is safe and feasible.

关 键 词：胸骨上段小切口 主动脉弓部手术 浅低温 

分 类 号：R654.2[医药卫生—外科学]