36 例急性Stanford A 型主动脉夹层动脉瘤的外科治疗体会

目的:总结急性Stanford A型主动脉夹层动脉瘤的外科治疗体会。方法:选择36例急性Stanford A型主动脉夹层动脉瘤患者,根据病变夹层破口的位置、累及范围、有无合并主动瓣关闭不全选择相应的手术方式,观察患者治疗后的临床疗效并随访治疗6个月后的临床预后。结果:3例患者术中死亡,术中死亡率为8.3%,平均手术时间156.7±56.7min,平均阻断时间98.5±32.7min,平均选择性脑灌注时间56.1±20.7min,术后平均ICU住院时间6.2±3.8d,术后平均总计住院时间25.4±7.3d;术后6个月后随访,3例患者死亡,其余30例患者恢复满意,生活质量与治疗前相比,均得到显著提高。结论:急性Stanford A型主动脉夹层动脉瘤患者应积极施行早期外科治疗,术前快速准确诊断,根据患者病情制定相应的手术方案,术后采取措施避免术后并发症。

The Surgical Treatment Experience of 36 Cases of Acute Stanford A Aortic Dissection

Objective: To summarize the surgical treatment experience of 36 cases of acute Stanford A aortic dissection.Methods:Collect 36 patients with Stanford A aortic dissection,according to the patients’ specific conditions,observe the patients’ clinical effect after treatment and follow-up the clinical outcome after 6 months’ treatment.Results: 3 patients were died,the intraoperative mortality rate was 8.3%,the average operative time was 156.7±56.7min,the average blocking time was 98.5±32.7min,the average selective cerebral perfusion time was 56.1±20.7min,the average mean postoperative ICU length of stay was 6.2±3.8d,the average postoperative total hospital stay was 25.4±7.3d,there has a significant statistical in the quality of life.Conclusion: It could take early surgical treatment in the acute Stanford A aortic dissection in the patients,fast and accurate preoperative diagnosis,develop appropriate surgical plan based on the patient’s condition,measures to avoid postoperative complications.