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[GRF(明胶-间苯二酚-甲醛)胶水在A型主动脉夹层手术中的疗效]

[Efficacy of GRF (gelatin-resorcin-formalin) glue on surgery for type A aortic dissection].

作者信息

Nakayama Y, Kitamura S, Kawachi K, Inoue K, Taniguchi S, Fukutomi M, Kobayashi S, Kawata T, Yoshida Y

机构信息

Department of Surgery III, Nara Medical College, Japan.

出版信息

Nihon Kyobu Geka Gakkai Zasshi. 1994 Jul;42(7):1021-6.

PMID:8089566
Abstract

The tissue biological adhesive GRF glue has been used in our department to have dissected aortic layers adhered and to reinforce the dissected aortic stumps during surgery for aortic dissection. From May 1992 to August 1993, 12 patients were operated for type A aortic dissection; 4 patients with acute dissection and 8 patients with chronic dissection. There were 5 men and 7 women whose ages ranged from 51 to 69 years with an average of 60.6 years. Replacement of the ascending aorta alone was performed for 6 patients. Replacement of both the ascending aorta and transverse arch was carried out for 4 patients, and replacement of the ascending aorta, transverse arch and the descending aorta was accomplished in 1 patient. Primary repair was performed for 1 patient with intraoperative acute dissection that occurred during surgery for mitral valve. There were no operative or hospital deaths. Preoperative aortic regurgitation was present in 5 patients. Following gluing the aortic root dissection, aortic regurgitation disappeared in all patients confirmed by postoperative aortograms. The use of GRF glue significantly reduced the average amount of intraoperative bleeding from 2893 ml to 1169 ml and also significantly reduced the use of Teflon felt strips for the proximal anastomosis. We believe that use of GRF glue can improve the surgical outcome for acute and chronic aortic dissection.

摘要

组织生物粘合剂GRF胶已在我科用于在主动脉夹层手术中使解剖的主动脉层粘连并加固解剖的主动脉残端。1992年5月至1993年8月,12例患者接受了A型主动脉夹层手术;4例急性夹层患者和8例慢性夹层患者。男性5例,女性7例,年龄51至69岁,平均60.6岁。6例患者仅进行了升主动脉置换。4例患者进行了升主动脉和横弓置换,1例患者完成了升主动脉、横弓和降主动脉置换。1例在二尖瓣手术中发生术中急性夹层的患者进行了一期修复。无手术或住院死亡病例。5例患者术前存在主动脉瓣反流。在对主动脉根部夹层进行粘合后,术后主动脉造影证实所有患者的主动脉瓣反流均消失。GRF胶的使用显著减少了术中平均出血量,从2893毫升降至1169毫升,还显著减少了用于近端吻合的聚四氟乙烯毡条的使用。我们认为,使用GRF胶可以改善急慢性主动脉夹层的手术效果。

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