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[中国A型主动脉夹层的研究进展与挑战]

[Progress and challenge of Stanford type A aortic dissection in China].

作者信息

Sun L Z, Li J R

机构信息

Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing 100029, China.

出版信息

Zhonghua Wai Ke Za Zhi. 2017 Apr 1;55(4):241-244. doi: 10.3760/cma.j.issn.0529-5815.2017.04.001.

Abstract

In recent 20 years, the rapid development of acute Stanford type A aortic dissection in China has been mainly due to three aspects: (1) the refined classification of aortic dissection based on Stanford classification, (2) right axillary artery canal and selective cerebral perfusion technology become basic cardiopulmonary bypass strategy for Stanford type A aortic dissection, and (3) total aortic arch replacement and descending aortic stent graft surgery (Sun's surgery) become the standard treatment of Stanford type A aortic dissection. However, there are still many problems in the diagnosis and treatment of aortic dissection in China, such as: (1) unstandardized, lack of comprehensive guidelines of aortic dissection, (2) immature, perioperative organ protection and intraoperative blood protection technology remains a big flaw, and (3) it takes a long time to get patient prepared for surgery. In conclusion, as to the issue of the management of acute Stanford type A aortic dissection, there will be a long way for Chinese doctors to go. Peers should pay more attention to this problem and take more efforts, so that the outcome of acute Stanford type A aortic dissection surgical patients can be improved.

摘要

近20年来,急性Stanford A型主动脉夹层在中国快速发展,主要得益于三个方面:(1)基于Stanford分类的主动脉夹层精细化分型;(2)右腋动脉插管及选择性脑灌注技术成为Stanford A型主动脉夹层的基本体外循环策略;(3)全主动脉弓置换及降主动脉支架象鼻手术(孙氏手术)成为Stanford A型主动脉夹层的标准治疗方式。然而,中国主动脉夹层的诊治仍存在诸多问题,比如:(1)不规范,缺乏主动脉夹层综合指南;(2)不成熟,围手术期器官保护及术中血液保护技术仍存在较大缺陷;(3)患者术前准备时间长。总之,对于急性Stanford A型主动脉夹层的治疗问题,中国医生还有很长的路要走。同行应更加关注这个问题并付出更多努力,以使急性Stanford A型主动脉夹层手术患者的预后得到改善。

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