妊娠合并急性Stanford A型主动脉夹层的治疗策略与结局  

The treatment strategy and outcome of pregnancy complicated with Stanford type A aortic dissection

作　　者：林培容[1] 赵丽云[1] 马骏[1] Lin Peirong;Zhao Liyun;Ma Jun(Department of Anesthesiology,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart,Lung and Vessel Disease,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院麻醉科,北京100029

出　　处：《中华医学杂志》2021年第38期3157-3160,共4页National Medical Journal of China

基　　金：北京市医院管理局临床医学发展专项(ZYLX201810)。

摘　　要：探讨妊娠合并急性Standford A型主动脉夹层的临床特点、治疗策略及治疗效果。回顾性纳入2010年6月至2020年7月在首都医科大学附属北京安贞医院收治的12例妊娠合并急性Stanford A型主动脉夹层患者的临床资料,分析其治疗策略和母儿结局。12例患者年龄为(29±5)岁,发病时间为孕16周至产后1个月。12例妊娠合并主动脉A型夹层孕妇全部接受外科手术治疗。3例产褥期患者优先妊娠,分娩后再行主动脉修复;4例患者优先主动脉修复;5例患者进行同期接生联合主动脉修复。在基于挽救母亲和胎儿生命的前提下,妊娠期合并主动脉A型夹层术前应多学科综合评估,根据妊娠时间、胎儿发育情况、主动脉病变程度决定治疗策略。To summarize the clinical characteristics and surgical treatment experience of pregnant women with acute Stanford type A aortic dissection.We collected the clinical data of 12 cases with acute aortic dissection during pregnancy and puerperal period from June 2010 to July 2020 in Beijing Anzhen Hospital and analyzed retrospectively,and summarize the clinical characteristics,treatment and outcomes for both mother and fetus.The age of these patients was(29±5)years old,and the onset time was from 16 weeks of gestation and 1 month after delivery.All the 12 patients underwent surgical treatment.The patients in the puerperium received aortic surgery after delivery.Four of them received the aortic surgery and continued pregnancy.Five of them underwent aortic repair and cesarean section simultaneously.Surgical treatment should be actively considered in pregnancy complicated with acute Stanford type A aortic dissection.Multi-disciplinary team cooperation can effectively improve the safety of the patients and fetus.

关 键 词：妊娠 主动脉A型夹层 治疗策略 临床结局 

分 类 号：R714.252[医药卫生—妇产科学]