Parker F B, Neville J F, Hanson E L, Mohiuddin S, Webb W R
Ann Thorac Surg. 1975 Apr;19(4):436-42. doi: 10.1016/s0003-4975(10)64045-3.
The therapy for acute dissecting aneurysm of the aorta remains a difficult problem for thoracic surgeons. Because of an excessive operative mortality in patients with acute dissection who were operated on within 24 hours of hospital admission, we have utilized intensive medical management to delay surgical intervention. Even patients with acute aortic insufficiency can be supported medically, allowing their operations to be delayed at least 3 weeks or longer. Since this policy has been implemented, there has been no operative mortality in our last 13 patients with acute dissection. Medical therapy as the definitive treatment is now reserved solely for Type III dissections or for patients who cannot be operated on for other reasons. This report outlines our rationale for therapy and our current method of managing acute dissection.
对胸外科医生来说，急性主动脉夹层动脉瘤的治疗仍然是个难题。由于在入院24小时内接受手术的急性夹层患者手术死亡率过高，我们采用强化内科治疗来推迟手术干预。即使是急性主动脉瓣关闭不全的患者也能通过内科治疗得到支持，从而使手术至少推迟3周或更长时间。自从实施这项政策以来，我们最近的13例急性夹层患者均无手术死亡。内科治疗作为确定性治疗现在仅用于III型夹层或因其他原因无法进行手术的患者。本报告概述了我们的治疗原理以及目前处理急性夹层的方法。
