Ⅱ型杂交治疗急性A型主动脉夹层的疗效分析  

Analysis of the efficacy of type II hybrid in the treatment of acute tapy A aortic dissection

作　　者：李晓宁[1] 张思雨 岳之峰 马洪亮[1] Li Xiaoning;Zhang Siyu;Yue Zhifeng;Ma Hongiang(Department of Extracorporeal Circulation Group,the Fourth Hospital of Hebei Medical University,Hebei Shijiazhuang 050000,China)

机构地区：[1]河北医科大学第四医院体外循环组,石家庄050000

出　　处：《中国体外循环杂志》2025年第2期118-121,共4页Chinese Journal of Extracorporeal Circulation

摘　　要：目的比较Ⅱ型杂交技术和改良孙氏手术治疗急性A型主动脉夹层(ATAAD)患者的早中期疗效,旨在评估Ⅱ型杂交技术治疗ATAAD的有效性。方法回顾性分析河北医科大学第四医院2020年2月至2023年12月行全主动脉弓替换手术的患者,本次研究共入选患者90例,其中45例接受了改良全主动脉弓置换及象鼻支架置入术(改良组),45例接受了一期Ⅱ型杂交修复术(杂交组),所有患者手术均完成顺利。结果改良组年龄60岁以上13例,杂交组11例(P=0.634),术前基础病高血压、糖尿病、冠心病两组比较差异无统计学意义(P>0.05),两组患者术前肾功能不全、心包填塞差异无统计学意义(P>0.05)。杂交组和改良组转机时间、主动脉阻断时间、低流量时间差异均有统计学意义(P<0.001)。患者术后拔管时间、ICU停留时间、术后住院时间、二次开胸止血例数,两组比较差异无统计学意义(P>0.05)。术后并发症仅在多器官功能障碍综合征上杂交组优于改良组(P<0.05)。结论Ⅱ型杂交治疗ATAAD能够缩短体外循环时间、主动脉阻断时间及低流量时间,术后并发症优于改良孙氏手术,但远期疗效仍需大样本进一步深入研究。Objective This study compared the early and mid-term efficacy of typeⅡhybridization technology and improved Sun’s surgery in patients with acute type A aortic dissection through retrospective analysis,aiming to evaluate the effectiveness of typeⅡhybridization technology in the treatment of type A aortic dissection.Methods Data of patients who underwent aortic arch replacement surgery from February 2020 to December 2023 at the Fourth Hospital of Hebei Medical University were retrospectively analyzed.A total of 90 patients were selected in this study,of which 45 had modified aortic arch replacement and elephant rhinoplasty stent placement(modified group),while the other 45 patients underwent a phase II hybrid repair surgery(hybrid group).All patients were performed surgey successfully.Results There were 13 cases in the modified group aged over 60 years and 11 cases in the hybrid group(P=0.634).There was no significant difference between preoperative hypertension,diabetes and coronary heart disease(P>0.05).The two groups had preoperative differences in preoperative hypertension,diabetes and coronary heart disease(P>0.05).There was no significant difference in renal insufficiency and pericardial tamponade(P>0.05).The transit time of the hybrid and improved groups was(191.31±30.61)min and(235.03±46.84)min,the aortic occlusion time was(130.67±26.50)min and(175.71±40.35)min,and the low flow time was(2.53±0.66)min and(5.64±3.47)min,the differences between the two groups were statistically significant(P<0.001).There was no significant difference between the patients in CICU residence time,postoperative hospitalization time,and secondary thoracic hemostasis cases(P>0.05).Multi-organ dysfunction syndrome was the only postoperative complications which was better in the hybrid group than that in the modified group(P<0.05).Conclusion Type II hybrid treatment for acute Stanford A aortic dissection can shorten the extracorporeal circulation time,aortic occlusion time and low flow time.The postoperative complications

关 键 词：Ⅱ型杂交 A型主动脉夹层 改良孙氏手术 全主动脉弓修复术 

分 类 号：R654.2[医药卫生—外科学]