主动脉壁包裹-右心房分流术在Bentall手术中的应用  

Application of Aortic Wall Wrapping-Right Atrial Shunt Operation in Bentall Surgery

作　　者：程远建 李瑞 游杰 刘林稳 李民杰 易超 王超 田祥 Cheng Yuanjian;Li Rui;You Jie(Panzhihua Central Hospital,Panzhihua,Sichuan 611067,China)

机构地区：[1]攀枝花市中心医院,四川攀枝花617067

出　　处：《四川医学》2022年第11期1107-1111,共5页Sichuan Medical Journal

基　　金：攀枝花市指导性科技计划项目(编号:2020ZD-S-2)。

摘　　要：目的研究主动脉壁包裹—右心房分流术在Bentall手术中的安全性及手术效果。方法回顾性分析2014年1月至2021年6月我院心胸外科52例行Bentall手术患者的临床资料,根据术中是否行分流术分为非分流组27例,主动脉根部置换采用传统Bentall手术;分流组25例,在传统Bentall手术基础上行主动脉壁包裹—右心房分流术。比较两组手术时长、术中主动脉阻断时间、术中出血量、红细胞输入量、入住ICU时长、术后住院天数、术前术后的心脏彩超指标。结果分流组患者手术时间、主动脉阻断时间、术中出血量、术中红细胞输入量、入住ICU时长、术后住院天数较非分流组显著减少,差异有统计学意义(P<0.05),两组患者术中输入血浆、术前与术后超声心动图检查左室射血分数、左心室缩短分数、肺动脉压差异无统计学意义(P>0.05)。结论与传统Bentall术相比,主动脉壁包裹—右心房分流术在Bentall手术中可缩短手术时间及阻断时间、减少术中出血量和输血量,从而改善手术效果、减少出血相关并发症、提高手术成功率。Objective To summarize safety and efficacy of aortic wall wrapping-right atrial shunt operation in Bentall surgery.Methods From January 2014 to June 2021,clinical data of 52 patients undergoing Bentall surgery were retrospectively analyzed.52 patients were divided into non-shunt group and shunt group.Non-shunt group contained 27 cases which performed conventional Bentall operation in aortic root replacement,and shunt group contained 25 cases which performed aortic wall wrapping-right atrial shunt on the basis of conventional Bentall operation.The operation duration,aortic cross-clamp duration time,intraoperative bleeding volume,red blood cell input,ICU length of stay,postoperative length of stay,and preoperative and postoperative color ultrasound parameters were compared.Results Compared with non-shunt group,operation duration,aortic cross-clamp duration time,intraoperative bleeding volume,red blood cell input,ICU length of stay,and postoperative length of stay of shunt group were significantly reduced(P<0.05).And there were no significant differences in intraoperative plasma input volume,preoperative and postoperative left ventricular ejection fraction and shortening fraction or pulmonary artery pressure(P>0.05).Conclusion Compared with conventional Bentall surgery,aortic wall wrapping-right atrial shunt operation could shorten operation duration and aortic cross-clamp duration time,reduce intraoperative bleeding volume and blood transfusion volume,thus improving surgical effect,reducing bleeding related complications and improving success rate of surgery.

关 键 词：主动脉根部置换 BENTALL手术 主动脉壁包裹 右心房分流 

分 类 号：R543.1[医药卫生—心血管疾病]