摘要
目的:探讨3D打印技术辅助的个体化组合支架在Stanford A型主动脉夹层外科治疗中的效果,并与传统孙氏手术进行对比分析。方法:选取2017年9月—2021年7月安徽医科大学第二附属医院收治住院的37例Stanford A型主动脉夹层患者资料,按手术方式分为3D打印技术辅助的个体化支架手术组(观察组)17例和孙氏手术组(对照组)20例。术前患者均进行心脏超声、主动脉CT血管造影(CTA)、肝肾功能、血电解质、血常规等检查。统计并分析患者手术及体外循环相关数据,术后统计住院时间、ICU监护时间等指标。患者术后1个月进行临床随访,复查超声心动图及主动脉CTA。结果:2组患者手术顺利,术中无死亡。对照组和观察组手术时间[(377.70±80.35)min vs(311.18±74.53)min,P<0.05]、体外循环时间[(168.80±24.28)min vs(147.71±24.77)min,P<0.05]、术中停循环时间[(18.70±4.04)min vs(9.12±4.90)min,P<0.05]、ICU监护治疗时间[(7.61±1.79)d vs(6.25±1.29)d,P<0.05]、呼吸机使用时间[(4.46±1.52)d vs(3.03±0.77)d,P<0.05]、术后住院时间[(19.06±5.71)d vs(15.69±1.96)d,P<0.05]比较,差异均有统计学意义。观察组与对照组均全部一次关胸,无二次手术。术后对照组死亡2例,治愈出院18例,观察组自动出院1例,治愈出院16例。出院患者术后1个月随访无死亡病例,所有患者均复查主动脉CTA及心脏超声,结果提示主动脉弓、降主动脉血流通畅,支架血管位置正常,扩张良好,无位移、狭窄,支架周围无造影剂外渗,心功能良好。结论:3D打印技术辅助的个体化组合支架治疗Stanford A型主动脉夹层效果较好,可减少手术时间、体外循环时间及术中停循环时间。在降低手术难度的同时,减少了术后并发症的发生,有助于降低患者死亡率,术后早期复查效果满意。
Objective:To discuss the effect of 3 D printing technology-assisted individualized combined stent in the surgical treatment of Stanford A-type aortic dissection,and compare it with traditional Sun’s surgery.Methods:The data of 37 patients with Stanford type A aortic dissection admitted to the hospital from September 2017 to July 2021 were selected.According to the operation method,they were divided into 3 D printing technology-assisted individualized combined stent surgery group(observation group)with 17 cases and Sun’s surgery group(control group)with 20 cases.Before surgery,all patients underwent cardiac ultrasound,aortic angiography,liver and kidney function,blood electrolyte,blood routine,and other inspections and tests.Observation data related to patients’surgery and cardiopulmonary bypass,as well as postoperative hospitalization time,ICU monitoring time,and other observation indicators were counted and analyzed.The patient underwent clinical follow-up 1 month after surgery and rechecked echocardiography and aortic CTA.Results:The operation of patients in two groups was successful,and there was no death during the operation.In the control group and observation group,operation time[(377.70±80.35)min vs(311.18±74.53)min,P<0.05],cardiopulmonary bypass time[(168.80±24.28)min vs(147.71±24.77)min,P<0.05],intraoperative circulatory arrest time[(18.70±4.04)min vs(9.12±4.90)min,P<0.05],ICU monitoring and treatment time[(7.61±1.79)d vs(6.25±1.29)d,P<0.05],respiration machine usage time[(4.46±1.52)d vs(3.03±0.77)d,P<0.05],postoperative hospital stay[(19.06±5.71)d vs(15.69±1.96)d,P<0.05]were different significantly.Both the observation group and the control group had their chests closed at one time without secondary surgery.After the operation,2 cases died and18 cases were cured and discharged in the control group.One case was discharged automatically and 16 cases were cured and discharged in the observation group.The discharged patients were followed up for 1 month after the operation,and there was no
作者
张靓
严中亚
申运华
卢中
ZHANG Liang;YAN Zhongya;SHEN Yunhua;LU Zhong(Department of Cardiovascular Surgery,The Second Hospital of Anhui Medical University,Hefei,230601,China)
出处
《临床心血管病杂志》
CAS
北大核心
2022年第6期444-448,共5页
Journal of Clinical Cardiology
基金
安徽省科技攻关项目(No:1301042198)。
