摘要
目的探讨双环三明治法在急性A型主动脉夹层手术根部吻合中应用的疗效及安全性。方法2020年10月~2023年5月收治急性A型主动脉夹层病人103例,术中应用双环三明治法对主动脉根部进行处理,分析手术效果、短期心脏结构变化及术后短期并发症发生情况等。结果所有病人术中加针止血比例11.65%,围手术期红细胞输注量(2.95±1.97)U,血浆输注量(543.68±208.48)ml,血小板输注量(0.08±0.30)U。术后2周心脏超声主动脉瓣残存返流、心功能、心包积液均较术前明显改善,差异有统计学意义(P<0.05)。术后主动脉根部残存假腔比例明显减少,差异有统计学意义(P<0.05)。病人住院时间、插管时间、术后24小时引流均较少。术后二次开胸、脑梗塞、脑出血、血滤、气管切开、死亡等术后短期并发症发生概率均较低。结论急性A型主动脉夹层手术中应用双环三明治法行主动脉根部吻合可有效封闭根部的夹层假腔,降低主动脉内膜撕脱风险,手术安全性及疗效较为可靠。
Objective To analyze the efficacy and safety of double-ring sandwich procedure in the treatment of acute A-type aortic dissection root.Methods The clinical data of 103 patients with acute A-type aortic dissection treated by double-ring sandwich procedure in our center from October 2020 to May 2023 were retrospectively analyzed to investigate the surgical effect,short-term cardiac structural changes and short-term postoperative complications.Results Needle hemostasis was applied in 11.65%of all patients.The amount of red blood cell transfusion during the perioperative period was(2.95±1.97)U,plasma was(543.68±208.48)ml,and blood platelet was(0.08±0.30)U.The residual aortic regurgitation,cardiac function and pericardial effusion were significantly improved at 2 weeks after operation(P<0.05).The proportion of residual false lumen in the aortic root was significantly reduced after operation(P<0.05).The length of hospital stay,duration of intubation,and drainage within 24 hours after surgery were less.The incidence of postoperative short-term complications such as secondary thoracotomy,cerebral infarction,cerebral hemorrhage,hemofiltration,tracheal incision and death was low.Conclusions Double-ring sandwich procedure in the treatment of acute A-type aortic dissection can effectively block the false lumen of aortic root dissection,reduce the risk of aortic intimal avulsion,and the operation is safe and effective.
作者
刘巍梁
王学宁
段普
杨灵波
LIU Weiliang;WANG Xuening;DUAN Pu;YANG Lingbo(Department of Cardiovascular Surgery,Shanxi Bethune Hospital,Shanxi Academy of Medical Sciences,Third Hospital of Shanxi Medical University,Tongji Shanxi Hospital,Taiyuan 030032,China)
出处
《临床外科杂志》
2024年第8期836-839,共4页
Journal of Clinical Surgery
关键词
急性A型主动脉夹层
双环三明治法
主动脉根部吻合
临床应用
acute A-type aortic dissection
sandwich procedure
root of aortic dissection
clinical application
