主动脉弓分支优先技术在急性Standford A型主动脉夹层治疗中的有效性  

Effectiveness of aortic arch branching priority technique in acute Standford type A aortic dissection

作　　者：倪良春[1] 仇杰[1] 郭晓珂 宗良[1] 程前进[1] 李祥[1] NI Liang-chun;QIU Jie;GUO Xiao-ke(Department of Cardiac Surgery,Affiliated Hospital of Jining Medical College,Jining Shandong 272029,China.)

机构地区：[1]济宁医学院附属医院心外科,山东济宁272029

出　　处：《临床和实验医学杂志》2022年第19期2025-2028,共4页Journal of Clinical and Experimental Medicine

基　　金：山东省中医药科技发展计划项目(编号:2019-0474)。

摘　　要：目的探讨急性Standford A型主动脉夹层治疗中应用主动脉弓分支优先技术的有效性。方法回顾性选取2020年2月至2021年2月济宁医学院附属医院收治的急性Standford A型主动脉夹层患者60例,依据手术程序分为主动脉弓分支优先技术重建的孙氏手术程序组(分支优先组)、经典孙氏手术程序组(经典手术组)两组,各30例。比较两组患者的围术期指标、术后并发症发生情况、二次开胸、气管切开、术后透析情况、生活质量、满意度。结果分支优先组患者的心肺转流时间、心肌阻断时间、ICU停留时间、机械通气时间、恢复清醒时间及住院时间均明显短于经典手术组,术后24 h引流量明显低于经典手术组,术中最低鼻咽温度和术中血浆输注量均明显高于经典手术组,差异均有统计学意义(P<0.05);两组患者停循环或选择性脑灌注时间、术中红细胞输注量、术中血小板输注量比较,差异均无统计学意义(P>0.05)。分支优先组患者的术后并发症发生率为16.67%,明显低于经典手术组(40.00%),差异有统计学意义(P<0.05)。手术后,分支优先组患者的疼痛、疲乏、精神、睡眠、食欲、日常生活评分均明显高于经典手术组,差异均有统计学意义(P<0.05)。分支优先组患者的满意度为90.00%,明显高于经典手术组(63.33%),差异有统计学意义(P<0.05)。结论急性Standford A型主动脉夹层治疗中应用主动脉弓分支优先技术重建的孙氏手术程序较经典孙氏手术程序能明显改善患者的围术期指标,降低术后并发症发生率,提高患者的生活质量和满意度。Objective To investigate the effectiveness of aortic arch branching priority technique in the treatment of acute Standford type A aortic dissection.Methods Sixty patients with acute Standford type A aortic dissection in Affiliated Hospital of Jining Medical College from February 2020 to February 2021 were retrospectively selected.They were divided into two groups according to the surgical procedures:classical Sun procedure group(classical surgery group)and Sun procedure group(branch priority group),with 30 patients in each group.The perioperative indicators,postoperative complications,secondary thoracotomy,tracheotomy,postoperative dialysis,quality of life and satisfaction of the two groups were statistically analyzed.Results The cardiopulmonary bypass time,myocardial block time,ICU stay time,mechanical ventilation time,recovery time and hospitalization time of the branch priority group were significantly shorter than those of the classic surgery group,and the drainage volume 24 h after surgery was significantly lower than that of the classic surgery group,the lowest intraoperative nasopharyngeal temperature and intraoperative plasma infusion volume were significantly higher than those in the classical surgery group,and the differences were statistically significant(P<0.05).There was no significant difference in the time of circulatory arrest or selective cerebral perfusion,intraoperative red blood cell transfusion volume and intraoperative platelet transfusion volume between the two groups(P>0.05).The incidence of postoperative complications in the branch priority group was 16.67%,which was lower than that in the classical surgery group(40.00%),and the difference was statistically significant(P<0.05).After operation,the scores of pain,fatigue,spirit,sleep,appetite and daily life in the branch priority group were higher than those in the classical operation group,and the differences were statistically significant(P<0.05).The satisfaction of patients in the branch priority group was 90.00%,which was higher than th

关 键 词：急性Standford A型主动脉夹层 经典孙氏手术程序 主动脉弓分支优先技术 并发症 生活质量 满意度 

分 类 号：R654.3[医药卫生—外科学]