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Stanford A型主动脉夹层的外科治疗

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摘要 目的总结Stanford A型主动脉夹层(aortic dissection,AD)手术治疗经验。方法 90例Stanford A型AD患者,其中急性45例,亚急性35例,慢性10例。手术方式包括:Bentall术6例、Wheat术4例、David术2例、Bentall及右半弓置换3例、Bentall+全弓置换+象鼻术28例、Wheat+全弓置换+象鼻术36例、David+全弓置换+象鼻术9例、Cabrol+全弓置换+象鼻术2例。在75例象鼻术中56例采用改良手术,其中在覆膜支架上对应未受累头臂干血管开口处开窗41例,采用三分支支架象鼻术15例。结果 84例患者治愈,死亡6例(6.7%)。结论 Stanford A型主动脉夹层诊断明确后应尽早手术治疗,并根据内膜破口位置、夹层的范围决定手术范围和方式;对主动脉弓部处理的改良可防止术后并发症发生,降低病死率。
出处 《广东医学》 CAS CSCD 北大核心 2010年第21期2817-2819,共3页 Guangdong Medical Journal
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