摘要
目的:总结老年A型主动脉夹层的围手术期处理经验,提高老年主动脉夹层手术疗效。方法:主动脉夹层手术的老年患者31例,其中男25例,女6例,年龄61-78岁,平均65岁。术前严密控制血压心率并完善术前准备,升主动脉根据受累部位采用Wheat、Bentall、David术,弓部及远端均行全弓置换+支架象鼻术,术后带气管插管入重症监护室(ICU)进行严密系统监护,积极防治可能出现的并发症。结果:术后早期死亡2例(6.5%),神经系统并发症4例,切口愈合不良2例,血管吻合口出血1例;肾功能衰竭3例,1例治愈,2例放弃治疗出院。结论:充分的术前准备和规范完善的围术期处理是提高老年A型主动脉夹层手术疗效的关键。
Objective： To summarize the experience of perioperative management for type A aortic dissection in elderly patients.Methods： Thirty-one cases of elderly patients,including 25 males and 6 females,underwent aortic dissection operations in the cardiovascular surgery department of Renmin Hospital of Wuhan University during September 2008 to May 2011.The age ranged from 61 to 78 years,and the average age of was 65 years.Before the surgery,the blood pressure and heart rate were controlled well.The Wheat,Bentall or David operation respectively was performed according to the involvement of aortic dissection,as well as the total arch replacement combined with stent-graft elephant trunk technique on the arch and distal of the aorta were performed in all cases.After the surgery,the patients were admitted to ICU with endotracheal intubation,and the possible complications were monitored and prevented.Results： Two cases died in the early postoperation（6.5%）,four cases had nervous system complication,two cases had poor wound healing,one case had hemorrhage of anastomosis,and three cases had renal dysfunction（one case cured after active treatment and the other two cases gave up treatment and left the hospital）.Conclusion： Sufficient preoperative preparation,normative and perfect perioperative management is the key to improve curative effect of the elderly type A aortic dissection surgery.
出处
《武汉大学学报（医学版）》
CAS
北大核心
2012年第4期590-593,共4页
Medical Journal of Wuhan University
关键词
老年
A型主动脉夹层
围术期
心脏外科手术
Senile
Type A Aortic Dissection
Perioperative Cardiac Surgical Procedures
