新型弓部阻断孙氏手术治疗急性Stanford A型主动脉夹层—单中心67例早期临床结果分析  

New aortic arch-clamping technique in Sun’s procedure to repair acute Type A aortic dissection: an early clinical analysis of 67 cases in a single center

作　　者：罗程 贾博 钟永亮[1] 葛翼鹏[1] 里程楠[1] 乔志钰[1] 胡海瓯[1] 朱俊明[1] Luo Cheng;Jia Bo;Zhong Yongliang;Ge Yipeng;Li Chengnan;Qiao Zhiyu;Hu Haiou;Zhu Junming(Department of Cardiovascular Surgery,Beijing Aortic Disease Centre,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart Lung and Blood Vessel Diseases,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院心血管外科、北京市心肺血管疾病研究所、北京市大血管疾病诊疗研究中心,北京100029

出　　处：《中华胸心血管外科杂志》2023年第9期564-567,共4页Chinese Journal of Thoracic and Cardiovascular Surgery

基　　金：北京市科技计划项目(Z191100006619094)。

摘　　要：目的评估新型弓部阻断孙氏手术治疗急性Stanford A型夹主动脉夹层的安全性和有效性。方法回顾性分析安贞医院2019年12月至2022年12月期间67例急性Stanford A型主动脉夹层患者施行新型弓部阻断孙氏手术的临床资料, 分析其早期临床结果。结果本组患者体外循环时间(166.66±32.81)min, 主动脉阻断时间(100.49±19.96)min, 停循环时间(3.97±1.63)min, 最低鼻咽温度(25.716±1.304)℃, 最低膀胱温度(26.209±1.552)℃。全组患者住院死亡2例(2.98%), 脑梗塞3例(4.48%), 短暂性神经功能障碍4例(5.97%), 截瘫1例(1.49%), 需持续透析的肾衰竭4例(5.97%)。结论新型弓部阻断技术应用于急性Stanford A型主动脉夹层患者安全可靠, 是提高孙氏手术治疗急性Stanford A型主动脉夹层疗效的新策略。Objective To evaluate the efficacy of new arch-clamping technique in Sun’s procedure to repair acute type A aortic dissection.Methods 67 consecutive patients with acute type A aortic dissection who underwent total arch replacement and frozen elephant trunk implantation(TAR+FET)from Dec 2019 to Dec 2022 with using new arch-clamping technique during operation.Relative intraoperative and postoperative variables and complications were compared.Results Cardiopulmonary bypass time was(166.66±32.81)min,the aortic occlusion time was(100.49±19.96)min,the circulatory arrest time was(3.97±1.63)min,the lowest nasopharyngeal temperature was(25.716±1.304)℃,and the lowest bladder temperature was(26.209±1.552)℃.The whole group died in hospital in 2 cases(2.98%),cerebral infarction in 3 cases(4.48%),transient neurological dysfunction in 4 cases(5.97%),paraplegia patients in 1 case(1.49%),renal failure requiring continuous dialysis in 4 cases(5.97%).Conclusion New arch-clamping technique decrease postoperative complication,and is a safe and feasible innovative approach to effectively improve surgical outcome of Sun’s procedure for repair of acute type A aortic dissection.

关 键 词：新型弓部阻断技术 急性Stanford A型主动脉夹层 孙氏手术 

分 类 号：R654.2[医药卫生—外科学]