妊娠合并急性Stanford A型主动脉夹层的处置策略

发布时间：2018-04-23 06:57

本文选题：妊娠期主动脉夹层 + 手术方式　；参考：《南方医科大学学报》2017年11期

【摘要】：目的探讨妊娠合并急性Stanford A型主动脉夹层的诊治方法,以提高母婴救治成功率。方法回顾性分析2009年6月~2017年2月广东省人民医院5例妊娠期患急性Stanford A型主动脉夹层孕妇围术期资料,通过对孕周及夹层病变程度、全身影响程度分析手术方式和时机。结果 5例患者中位年龄30岁(22~34岁),发病时孕周23~38周;5例均接受手术治疗,3例同期行剖宫产+子宫切除,2例继续妊娠。术后1例死于并发症。剖宫产3例胎儿均存活,继续妊娠者,1例胎儿宫内死亡,1例引产。随访期间,降主动脉支架无内漏,夹层远端无扩大。结论在基于挽救母亲和胎儿生命的前提下,急性Stanford A型主动脉夹层孕妇术前应多学科综合评估,根据妊娠时间、胎儿发育情况、主动脉病变程度决定手术方案。
[Abstract]:Objective to investigate the diagnosis and treatment of acute Stanford A aortic dissection in pregnancy and improve the success rate of maternal and infant treatment. Methods the perioperative data of 5 pregnant women with acute Stanford A aortic dissection in Guangdong Provincial people's Hospital from June 2009 to February 2017 were analyzed retrospectively. Results the median age of 5 patients was 30 years old and 22 / 34 years old. All the 5 cases received surgical treatment at the age of 2338 weeks and 3 cases underwent cesarean hysterectomy and 2 cases continued pregnancy. One patient died of complications after operation. All 3 fetuses survived by cesarean section, and 1 fetus died in 1 case of intrauterine death and 1 case induced labor. During the follow-up period, the descending aortic stents did not leak and the distal dissection did not expand. Conclusion based on the premise of saving mother's and fetus's life, acute Stanford A aortic dissection pregnant women should be evaluated comprehensively before operation. According to gestation time, fetal development and degree of aortic lesion, surgical scheme should be decided.
【作者单位】：广东省心血管病研究所//广东省人民医院//广东省医学科学院心外科;广东省心血管病研究所//广东省人民医院//广东省医学科学院产科;
【基金】：广东省省级科技计划项目(2015A020214017) 广东省医学科学技术研究基金项目(201611810048265)
【分类号】：R714.252

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