升主动脉至股髂动脉搭桥术在复杂主动脉疾病外科治疗中的应用
发布时间：2019-02-19 16:06
【摘要】：目的回顾性分析32例主动脉夹层病变患者的临床资料,探讨升主动脉至股(髂)动脉旁路术在外科治疗中的应用,提高对此类患者外科治疗的认识。方法收集2004年10月至2013年12月,我院32例广泛主动脉夹层病变患者,男性28例(87.5%),女性4例(12.5%),年龄平均(42±9)岁。32名患者病变类型包括：28例A型夹层(12例急性夹层,16例慢性夹层),4例B型夹层伴升主动脉瘤(均为慢性夹层)。随访途径包括门诊复查主动脉CT和电话随访。结果在本组32例患者中,升主动脉及主动脉弓部手术操作包括：25例行升主动脉-全弓+支架象鼻术,5例行Bentall+全弓-支架象鼻术,2例行Wheat+全弓十支架象鼻术。32例患者均行升主动脉至右髂(或右股)旁路术。体外循环时间平均(206±66)min。停循环时间平均(26±10)min。住院时间平均(20±11)天。术后住院期间,2例患者死于多种严重的并发症。术后24例出院患者返院复查CT(二期手术患者CT随访截止至二期术前),CT随访率80%,CT随访时间平均(9±7)个月。术后出院患者电话随访,2例失访,电话随访率93%。随访期间无死亡病例。结论对于广泛主动脉夹层病变的患者,在升弓部手术后,升主动脉至单侧股(髂)动脉人工血管旁路术可于术后早期缓解远端残余主动脉病变的进展,同时能简化二期手术。
[Abstract]:Objective to analyze retrospectively the clinical data of 32 patients with aortic dissection, to explore the application of ascending aorta to femoral artery bypass in surgical treatment, and to improve the understanding of surgical treatment of these patients. Methods from October 2004 to December 2013, 32 patients with extensive aortic dissection, including 28 males (87.5%) and 4 females (12.5%), were collected. The mean age of 32 patients was (42 卤9) years old. There were 28 patients with type A dissection (12 with acute dissection and 16 with chronic dissection) and 4 patients with type B dissection with ascending aortic aneurysm (all chronic dissection). The follow-up included outpatient review of aortic CT and telephone follow-up. Results among the 32 patients, the ascending aorta and aortic arch were operated on: 25 cases underwent ascending aorta total arch stenting rhinoplasty, 5 cases Bentall total arch stents rhinoplasty. 32 patients underwent ascending aorta to right iliac (or right femoral) bypass. Mean CPB time (206 卤66) min. Circulatory arrest time averaged (26 卤10) min. The average hospital stay was (20 卤11) days. During hospitalization, 2 patients died of multiple severe complications. 24 patients who were discharged from hospital returned to hospital to check up CT (CT follow-up of secondary operation ended to the follow-up rate of), CT before secondary operation 80%). The average follow-up time was (9 卤7) months. Telephone follow-up was performed in 2 patients, and the telephone follow-up rate was 933%. There were no deaths during follow-up. Conclusion for the patients with extensive aortic dissection, the ascending aorta to unilateral femoral (iliac) artery bypass surgery can relieve the progression of distal residual aortic lesions early after the operation, and can simplify the secondary operation at the same time.
【学位授予单位】：北京协和医学院
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R654.2
本文编号：2426655
[Abstract]:Objective to analyze retrospectively the clinical data of 32 patients with aortic dissection, to explore the application of ascending aorta to femoral artery bypass in surgical treatment, and to improve the understanding of surgical treatment of these patients. Methods from October 2004 to December 2013, 32 patients with extensive aortic dissection, including 28 males (87.5%) and 4 females (12.5%), were collected. The mean age of 32 patients was (42 卤9) years old. There were 28 patients with type A dissection (12 with acute dissection and 16 with chronic dissection) and 4 patients with type B dissection with ascending aortic aneurysm (all chronic dissection). The follow-up included outpatient review of aortic CT and telephone follow-up. Results among the 32 patients, the ascending aorta and aortic arch were operated on: 25 cases underwent ascending aorta total arch stenting rhinoplasty, 5 cases Bentall total arch stents rhinoplasty. 32 patients underwent ascending aorta to right iliac (or right femoral) bypass. Mean CPB time (206 卤66) min. Circulatory arrest time averaged (26 卤10) min. The average hospital stay was (20 卤11) days. During hospitalization, 2 patients died of multiple severe complications. 24 patients who were discharged from hospital returned to hospital to check up CT (CT follow-up of secondary operation ended to the follow-up rate of), CT before secondary operation 80%). The average follow-up time was (9 卤7) months. Telephone follow-up was performed in 2 patients, and the telephone follow-up rate was 933%. There were no deaths during follow-up. Conclusion for the patients with extensive aortic dissection, the ascending aorta to unilateral femoral (iliac) artery bypass surgery can relieve the progression of distal residual aortic lesions early after the operation, and can simplify the secondary operation at the same time.
【学位授予单位】：北京协和医学院
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R654.2
【参考文献】
相关期刊论文 前1条
1 孙立忠,谢涌泉,常谦,冯钧,郭岩,朱俊明;再次及多次主动脉瘤手术的临床分析[J];中华胸心血管外科杂志;2001年06期
，本文编号：2426655
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