胸主动脉夹层动脉瘤的外科治疗  

Surgical treatment of thoracic aortic dissecting aneurysm

作　　者：吴起才[1] 万于华[1] 刘晓明[1] 饶华庚[1] 陈干[1] 王勤[1] 李志平[1] 刘升[1] 

机构地区：[1]江西医学院一附院心胸外科,南昌330006

出　　处：《江西医药》2003年第4期234-236,共3页Jiangxi Medical Journal

摘　　要：目的总结胸主动脉夹层动脉瘤外科治疗经验。方法DeBakeyⅠ型4例,均在深低温停循环时应用右锁骨下动脉插管选择性脑灌注下,以复合带瓣人工血管组件替换主动脉根部(Bentall术)3例,人工血管置换升主动脉1例;DeBakeyⅡ型1例,在股动脉插管体外循环下完成Bentall术;DeBakeyⅢ型1例,在介入下以带膜支架人工血管行主动脉腔内隔绝术。结果无手术死亡,均痊愈出院,术后随访,心功能良好。结论胸主动脉夹层动脉瘤手术时,体外循环方法的选择和适当的外科吻合技术是手术成功的两个重要因素。Objective To summarize the experi-ences of surgical treatment of t horacic aortic dis-secting aneurysm.Methods In the4patients of DeBakey typeⅠ,ao rtic root replacement was per-formed with composite valved graft(Bentall)in3pa-tients,and1patient replaced the ascending aorta with Dacron graft under deep hy pothemic circulato-ry arrest and selected cerebral perfusion using right subcla vian arterial cannulation technique;Bentall was used in1patient of DeBakey type Ⅱduring cardiopulmonary bypass;Endovascular repair of de-scending aortic dissec tion was treated with stenting graft in1patient of DeBakey typeⅢ.Results There was no early and late death,cardiac function in the followed up were improved.C on clu sion Surgical technique combined with proper methods of CPB is the most i mportant factor for treatment of thoracic aortic dissecting aneurysm.

关 键 词：胸主动脉夹层动脉瘤 治疗 外科手术 深低温停循环 体外循环 

分 类 号：R732.21[医药卫生—肿瘤] R655[医药卫生—临床医学]