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《国际心血管病杂志》[ISSN:1006-6977/CN:61-1281/TN]

期数:

2019年03期

页码:

159-163

栏目:

临床研究

出版日期:

2019-05-27

文章信息/Info

Title:

Comparison of efficacy between Sun's operation and de-branching hybrid operation in the treatment of acute type Ⅰ aortic dissection

作者:

董帅 鄢光华 刘瑞生 祁泉 宋兵

730000 兰州大学第一临床医学院(董帅,鄢光华); 730000 兰州大学第一医院心血管外科(刘瑞生,祁泉,宋兵)

Author(s):

DONG Shuai¹;  YAN Guanghua¹;  LIU Ruisheng²;  Qi Quan²;  SONG Bin²

1. The First Clinical Medical College of Lanzhou University, Gansu 730000; 2. Department of Cardiovascular Surgery,The First Hospital of Lanzhou University, Gansu 730000, China

关键词:

Ⅰ型主动脉夹层;  孙氏手术;  杂交手术;  体外循环

Keywords:

Type Ⅰ aortic dissection;  Sun's procedure;  Hybrid operation;  Cardiopulmonary bypass

分类号:

-

DOI:

10.3969/j.issn.1673-6583.2019.03.008

文献标识码:

-

摘要:

目的:比较接受孙氏手术与去分支化杂交手术治疗的急性Ⅰ型主动脉夹层患者的围术期及术后短期预后。方法:纳入2015年3 月至2017年5月在兰州大学第一医院心血管外科行Ⅰ型主动脉夹层广泛修复手术患者85例,其中行孙氏手术患者(孙氏组)64例,行去分支化杂交手术患者(去分支化组)21例,比较两组患者围术期及术后短期生存状况。结果:与孙氏组相比,去分支化组患者年龄大,肥胖、术前合并肝功不全者比例高,主动脉阻断及体外循环时间短,术后呼吸机辅助呼吸时间短,围术期红细胞及冷沉淀使用量少,ICU住院时间及术后住院时间短,肺部感染率低(P均<0.05)。两组的在院死亡率和术后1年生存率无统计学差异。结论:去分支化杂交手术是治疗急性Ⅰ型主动脉夹层的新方法,适用于高龄、高危人群,短期预后良好。

Abstract:

Objective:Our goal was to compare the Sun's procedure and the hybrid aortic arch debranching procedure for acute Type Ⅰ aortic dissection.Methods:From March 2015 to May 2017, 85 patients with Type Ⅰ aortic dissection were analysed retrospectively who underwent extensive procedures by department of cardiovascular surgery in the first hospital of Lanzhou university.There were 64 patients underwent Sun's procedure(Sun's group)and 21 underwent hybrid aortic arch debranching procedure(hybrid aortic arch debranching group).Perioperative data and mid-term follow-up results were assessed.Results:In comparison with the Sun's group, the preoperative age, obesity rate and hepatic dysfunction rate were significantly higher in the hybrid aortic arch debranching group(all P<0.05).The operation time, clamp time, CBP time,ventilation time, ICU time and postoperative in-hospital time were shorter; pulmonary infection rate was lower and the use of red blood and plasma were less(all P<0.05).There were no significant differences in the 30-day mortality rate and annual survival rate between the two groups.Conclusions:The hybrid aortic arch procedure is a novel operation method, and can be safely performed on patients with acute Type Ⅰ aortic dissection, espically on high risk patients.

参考文献/References

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备注/Memo

备注/Memo:

通信作者:宋兵,Email:abcsong@sin.com

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更新日期/Last Update: 2019-05-27