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[斯坦福A型主动脉夹层的外科治疗]

[The surgical treatment for the Stanford type A aortic dissection].

作者信息

Fukaya Y, Nobara H, Nishimura K, Miwa H, Nakano H, Yanagiya N, Shinohara M, Morimoto M

机构信息

Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan.

出版信息

Nihon Kyobu Geka Gakkai Zasshi. 1992 Dec;40(12):2178-81.

PMID:1491196
Abstract

Twenty-nine patients who underwent operation at Shinshu University Hospital for the Stanford type A dissecting aneurysm were analysed. The patients were operated on in the acute stage within 2 weeks after onset. In 13 of these 26 acute cases, the graft replacement of the ascending and arch of the aorta was performed (group A). The patients were operated under a separate perfusion to the brain and the distal anastomosis to the proximal portion of the descending aorta was performed using the method of open distal anastomosis. In other 13 cases, the graft replacement of the ascending aorta was performed (group B). Operative mortality rate was 19% in this series (group A: 23%, group B: 15%). There was no significant difference in their operative mortality of acute stage. And there was also no significant difference in their post operative course of acute stage operations. We concluded that the graft replacement of the ascending and arch of the aorta was better than the graft replacement of the ascending aorta alone for the patients with Stanford type A acute aortic dissection.

摘要

对在信州大学医院接受手术治疗的29例斯坦福A型主动脉夹层动脉瘤患者进行了分析。这些患者在发病后2周内的急性期接受了手术。在这26例急性病例中的13例中,进行了升主动脉和主动脉弓的人工血管置换术(A组)。患者在脑部分别灌注下进行手术,并采用开放远端吻合术的方法对降主动脉近端进行远端吻合。在其他13例病例中,进行了升主动脉的人工血管置换术(B组)。该系列手术死亡率为19%(A组:23%,B组:15%)。急性期手术死亡率无显著差异。急性期手术后的病程也无显著差异。我们得出结论,对于斯坦福A型急性主动脉夹层患者,升主动脉和主动脉弓的人工血管置换术优于单纯升主动脉的人工血管置换术。

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