36例急性StanfordA型主动脉夹层动脉瘤的外科治疗体会

目的：总结急性StanfordA型主动脉夹层动脉瘤的外科治疗体会。方法：选择36例急性StanfordA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1．756．1±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.