DavidⅠ与Bentall术用于急性主动脉夹层的单中心疗效分析  

Single-center analysis of David I versus Bentall's procedure for acute aortic dissection

作　　者：刘洋[1] 马宁 张伟华[1] Liu Yang;Ma Ning;Zhang Weihua(Department of Cardiovascular Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院心血管外科,河南郑州450052

出　　处：《临床荟萃》2024年第5期420-425,共6页Clinical Focus

基　　金：省部共建青年项目DUSP14通过调控VEGFA可变剪接在心肌缺血再灌注损伤中的机制和功能研究(SBGJ202003049)。

摘　　要：目的比较单中心DavidⅠ与Bentall手术用于急性主动脉夹层的疗效。方法选取2020年1月至2022年12月于郑州大学第一附属医院心血管外科住院治疗的急性主动脉夹层患者28例,按照手术方法分为DavidⅠ组(n=13)和Bentall(n=15),DavidⅠ组采用DavidⅠ手术,Bentall组采用Bentall手术。随访1年,比较2组围术期相关指标、心脏指标、并发症。结果与Bentall组比较,DavidⅠ组手术时间、转机时间、主动脉阻断时间更长(P<0.05)。2组术中出血量、术后24 h引流量、呼吸机辅助时间、重症监护病房停留时间、住院时间差异均无统计学意义(P>0.05)。2组术前和术后1年左心室射血分数、升主动脉最大内径、左心室舒张末期内径差异均无统计学意义(P>0.05);与术前比较,DavidⅠ组术后1年左心室射血分数降低(P<0.05),2组术后1年升主动脉最大内径、左心室舒张末期内径均降低(P<0.05)。2组并发症发生率(46.1%vs 46.7%)差异无统计学意义(P>0.05)。结论DavidⅠ与Bentall手术应用于急性主动脉夹层治疗的早期指标,术后生存率、瓣膜相关并发症等无明显差异。Bentall手术的手术时间、转机时间、主动脉阻断时间更短。Objective A single-center analysis of the efficacy of David I versus Bentall procedure for acute aortic dissection was conducted.Methods A total of 28 patients with acute aortic dissection hospitalized in the Department of Cardiovascular Surgery,the First Affiliated Hospital of Zhengzhou University from January 2020 to December 2022 were enrolled.According to the surgical methods,they were divided into David I group(n=13,received David I procedure)and Bentall group(n=15,received Bentall’s procedure).After 1 year of follow-up,the inter-group perioperative indexes,cardiac indexes and complications were assessed.Results The operation time,transfer time and aortic occlusion time were significantly longer in David I group versus Bentall group(P<0.05).There were no significant differences in intraoperative blood loss,24 h postoperative drainage volume,ventilator-assisted time,intensive care unit stay time,and hospitalization time in David I group versus Bentall group(P>0.05).There was no significant inter-group difference in left ventricular ejection fraction(LVEF),maximum diameter of ascending aorta and left ventricular end-diastolic diameter(LVDD)before operation and on year 1 of operation(P>0.05).LVEF in David I group was significantly decreased on year 1 of operation than that before operation(P<0.05),and maximum diameter of ascending aorta and LVDD were significantly decreased on year 1 of operation in the both groups than those before operation(P<0.05).There was no inter-group significant difference in the incidence of complications(46.1%vs 46.7%,P>0.05).Conclusion There was no significant difference in postoperative survival rate and valvular complications between Bentall and DavidⅠprocedure in the treatment of acute aortic dissection.The Bentall procedure has a shorter operating time,transit time,and aortic occlusion time.

关 键 词：主动脉夹层 DavidⅠ手术 BENTALL手术 疗效 

分 类 号：R543.1[医药卫生—心血管疾病]