急性A型主动脉夹层术后循环衰竭经皮机械循环支持治疗进展  

Advances in mechanical circulatory support therapy after acute type A aortic dissection surgery

作　　者：郭驹[1] 宋云林[1] 于湘友[1] Guo Ju;Song Yunlin;Yu Xiangyou(Department of Intensive Care Medicine,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院重症医学二科,乌鲁木齐830054

出　　处：《中华胸心血管外科杂志》2024年第5期311-315,共5页Chinese Journal of Thoracic and Cardiovascular Surgery

基　　金：新疆维吾尔自治区自然科学基金(2022D01C227)。

摘　　要：主动脉夹层是指主动脉腔内高速、高压血流从主动脉内膜撕裂处进入中膜,形成夹层血肿并随着血液压力的驱动在主动脉中层内扩张、解离,造成真假两腔的病理改变的过程。主动脉夹层病死率极高,尤其是急性A型主动脉夹层。A型主动脉夹层一经发现,均应积极行手术治疗。外科手术仍然是A型主动脉夹层的标准治疗方法。尽管外科技术进步,A型主动脉夹层术后病死率依然很高。当主动脉夹层患者术后出现心源性休克常规治疗无效时,患者只能面对死亡。目前不断有机械循环辅助装置用于主动脉夹层术后心源性休克治疗的报道,现将相关进展进行综述。Aortic dissection(AD)is a condition in which high-velocity,high-pressure blood flow in the aortic lumen enters the mesentery through a tear in the aortic intima,forming a coarctation hematoma that expands and dissociates in the aortic mesentery,resulting in pathological changes in both the true and pseudolumen.Aortic dissection has a high morbidity and mortality rate,especially in acute type A aortic dissection.Once diagnosed,type A aortic dissection should be actively treated surgically.Surgery is still the gold standard of treatment for type A aortic dissection.Despite surgical advances,the postoperative mortality rate for type A aortic dissection remains high.When conventional treatment fails and patients develop postoperative cardiopulmonary dysfunction and circulatory collapse,in severe cases leading to death.The use of mechanical circulatory assist devices for the treatment of postoperative cardiogenic shock after aortic dissection has been reported on a constant schedule,and the latest developments are described in this review.

关 键 词：心源性休克 主动脉夹层 循环衰竭 标准治疗方法 主动脉腔 术后病死率 夹层血肿 外科手术 

分 类 号：R654.3[医药卫生—外科学]