摘要
目的总结杂交技术治疗累及弓部主动脉夹层的高危患者临床经验。方法回顾性分析2007年9月至2015年3月上海交通大学医学院附属新华医院采用杂交技术治疗主动脉夹层33例患者的临床资料（急性期8例，亚急性期15例，慢性期10例）。其中男22例，女11例，平均年龄（69±10）岁，术前美国麻醉师协会（ASA）评分均〉Ⅲ级，27例行同期手术、6例行分期行腔内修复术。结果33例患者技术成功率100％，平均住院天数为（16±6）d，住院期间因脑梗死死亡1例。脑卒中2例，肺部感染1例。肾功能衰竭2例。随访30例，随访时间3～66个月，平均（33±20）个月。随访期间死亡4例，其中主动脉手术相关死亡2例；发生内漏3例，1例I型内漏行二次杂交治疗。结论杂交技术治疗累及弓部的主动脉夹层创伤小，适用于基础病变较多，无法接受主动脉弓置换的高危患者。
Objective To summarize the experience of hybrid repair performed in high risk patients with dissection involving the aortic arch. Methods From Sep. 2007 to Mar. 2015, hybrid repair was performed in 33 high risk patients with dissection involving the aortic arch including acute （n = 8） , subacute （n = 15 ）, or chronic （n = 10 ） cases. Descripitive statistics were computed for continuous and categorical variables. Results There were 22 male and 11 female patients with a mean age of（69 ± 10）years, and ASA Physical Status HI - IV. Simultaneous （ n = 27 ） and staged （ n = 5, mean interval 5.0 ± 1.3 days） endovaseular repair were performed via femoral artery. The technical success rate was 100%. The average hospital stay was （16 ±6） days. One case died of cerebral infraction. There were two with strokes, one with pneumonia and two with renal failure as complications. Median follow-up was 47 months （ 3 - 66 months）. There were four deaths with two were related to aortic artery. Endoleak was found in 3 during follow-up. One type I endoleak was cured after remedy hybrid repair. Conclusions Hybrid repair performed in patients at high risk with dissection involving the aortic arch is less invasive with favorable medium and long-term outcomes.
出处
《中华普通外科杂志》
CSCD
北大核心
2016年第8期624-627,共4页
Chinese Journal of General Surgery
