心脏不停跳技术治疗非A非B型主动脉夹层的可行性及有效性分析  

Feasibility and effectiveness analysis of beating-heart technique in the treatment of non-A-non-B aortic dissection

作　　者：牛天羽 夏麟 葛玉光 杨忠路 刘宇 王璐 姜辉 NIU Tian-yu;XIA Lin;GE Yu-guang;YANG Zhong-lu;LIU Yu;WANG Lu;JIANG Hui(Graduate School of Dalian Medical University,Dalian 116000,China)

机构地区：[1]大连医科大学研究生院,辽宁大连116000 [2]北部战区总医院心血管外科,辽宁沈阳110016

出　　处：《创伤与急危重病医学》2024年第6期341-344,共4页Trauma and Critical Care Medicine

摘　　要：目的探讨心脏不停跳技术在非A非B型主动脉夹层(AD)手术中的可行性。方法选取2021年6月至2024年5月北部战区总医院收治的38例非A非B型AD患者,男性30例,女性8例,年龄(51.34±12.19)岁,年龄范围为26~77岁。根据不同的手术策略将患者为不停跳组(n=18)和停跳组(n=20)。对比两组患者的术中指标、术后指标及实验室指标。结果不停跳组患者的心脏于术中保持跳动,停跳组患者的心脏停跳时间为(59.55±17.00)min。不停跳组患者术后呼吸机使用时间、ICU停留时间较停跳组明显减少,差异有统计学意义(P<0.05)。不停跳组患者术后第2天、第3天的肌钙蛋白较停跳组明显减少,差异有统计学意义(P<0.05)。结论心脏不停跳技术对于非A非B型主动脉夹层具有较高的安全性及可行性。Objective To investigate the feasibility and effectiveness of beating-heart technique in non-A-non-B aortic dissection surgery.Methods A total of 38 patients who were diagnosed as non-A-non-B aortic dissection from June 2021 to May 2024 in the General Hospital of the Northern Theater Command were retrospective for this study.There were 30 males and 8 females,aged(51.34±12.19)years,ranging from 26 to 77 years.According to different surgical strategies,the patients were divided into the beating-heart group and the cardioplegic-arrest group.There are 18 patients in the beating-heart group and 20 patients in the cardioplegic-arrest group.Collect preoperative,intraoperative,and postoperative data of patients to observe the feasibility and effectiveness of the beating-heart technique in non-A-non-B aortic dissection surgery.Results The heart of patients in the beating-heart group remained beating during surgery,while the cardiac arrest time of patients in the cardioplegic-arrest group was(59.55±17.00)minutes.Compared with the cardioplegic-arrest group,the patients in the beating-heart group had significantly shorter postoperative ventilation time and ICU stay time,and the troponin T levels on the 2nd and 3rd day after surgery were significantly reduced,the difference was statistically significant(P<0.05).Conclusion The beating-heart technique has high feasibility and effectiveness for non-A-non-B aortic dissection.

关 键 词：不停跳心脏手术 主动脉夹层 胸骨上段切口 心肌保护 

分 类 号：R654.3[医药卫生—外科学]