股动脉和腋动脉插管策略在急性Stanford A型主动脉夹层中的疗效分析  

Efficacy analysis of femoral artery and axillary artery cannulation strategy in acute Stanford type A aortic dissection

作　　者：李春平[1] 任飞[1] 丁杭[1] 黄烽[1] Li Chunping;Ren Fei;Ding Hang;Huang Feng(Department of Cardiovascular Surgery,Provincial Clinical Medical College of Fujian Medical University/Fujian Province Hospital,Fuzhou 350001,Fujian,China)

机构地区：[1]福建医科大学省立临床医学院/福建省立医院心外一科,福建福州350001

出　　处：《血管与腔内血管外科杂志》2022年第2期133-136,共4页Journal of Vascular and Endovascular Surgery

基　　金：福建省2013-2014年度国家临床重点专科建设项目(国卫办医函[2013]544)。

摘　　要：目的探讨股动脉和腋动脉插管策略在急性Stanford A型主动脉夹层中的应用疗效。方法收集2011年1月至2021年1月福建医科大学省立临床医学院/福建省立医院收治的562例急性Stanford A型主动脉夹层患者的临床资料,所有患者均行手术治疗。根据插管策略不同将患者分为腋动脉组[n=328,行腋动脉插管建立体外循环(CPB)]和股动脉组(n=234,行股动脉插管建立体外循环)。比较两组患者的围手术期结果,包括术后30 d病死率、脑卒中发生率、CPB时间、主动脉阻断(ACC)时间、单侧脑灌注时间、肾功能衰竭发生率。结果股动脉组患者的术后30 d病死率和脑卒中发生率均高于腋动脉组患者,差异均有统计学意义(P<0.05);两组患者的CPB时间、ACC时间、单侧脑灌注时间、肾功能衰竭发生率比较,差异均无统计学意义(P>0.05)。结论行腋动脉插管术的急性Stanford A型主动脉夹层患者的术后病死率和脑卒中发生率更低。Objective To investigate the efficacy of femoral artery and axillary artery cannulation strategy in acute Stanford type A aortic dissection.Method The clinical data of 562 patients with acute Stanford type A aortic dissection admitted to Provincial Clinical Medical College of Fujian Medical University/Fujian Province Hospital from January 2011 to January 2021 were collected,and all patients received surgical treatment.The patients were divided into an axillary artery group[n=328,axillary artery cannulation to establish cardiopulmonary bypass(CPB)]and a femoral artery group(n=234,femoral artery cannulation to establish CPB)according to different intubation strategies.The perioperative outcomes,including 30-day postoperative mortality,stroke incidence,CPB time,aortic cross clamp(ACC)time,unilateral cerebral perfusion time,and incidence of renal failure.of the two groups of patients were compared.Result The postoperative 30-day mortality rate and the incidence of stroke in the femoral artery group were higher than those in the axillary artery group,and the difference was statistically significant(P<0.05).There were no significant differences in CPB time,ACC time,unilateral cerebral perfusion time,and incidence of renal failure between the two groups(P>0.05).Conclusion Axillary artery catheterization characterizes with a low postoperative mortality and stroke rate in patients with acute Stanford type A aortic dissection.

关 键 词：主动脉夹层 股动脉 腋动脉 插管 体外循环 疗效 脑卒中 

分 类 号：R543[医药卫生—心血管疾病]