创伤性主动脉破裂的手术治疗
Surgical management of traumatic aortic disruption.
作者信息
Sharma S, Reddy V, Ott G, Cobanoglu A
机构信息
Department of Surgery, Oregon Health Sciences University, Portland 97201, USA.
出版信息
Am J Surg. 1997 May;173(5):416-8. doi: 10.1016/S0002-9610(97)00061-5.
BACKGROUND
Acute traumatic disruption of the descending thoracic aorta is a life-threatening injury that requires emergent operative intervention. From May 1988 to August 1996, 27 patients have undergone surgical repair at our institution.
METHODS
Diagnosis of aortic disruption was confirmed in all patients by aortogram prior to aortic repair. A Gott shunt was used in 24 patients (89%) and partial femoral-femoral bypass in 1 patient (4%) for distal perfusion. A clamp-and-sew technique was used in 2 patients (7%).
RESULTS
Mean aortic clamp time was 44 +/- 3 minutes (range 22 to 80 minutes) in patients with distal perfusion via a Gott shunt. One patient (4%) died within 30 days of aortic repair due to multisystem organ failure. Paraplegia occurred in 1 patient (4%).
CONCLUSIONS
With a disciplined, diagnostic and surgical approach for patients with traumatic disruption of the descending thoracic aorta, it is possible to achieve excellent outcomes. The use of a Gott shunt is a simple and effective method for distal perfusion during the repair of traumatic aortic rupture.
背景
胸降主动脉急性创伤性破裂是一种危及生命的损伤，需要紧急手术干预。1988年5月至1996年8月，我院有27例患者接受了手术修复。
方法
所有患者在主动脉修复术前均通过主动脉造影确诊主动脉破裂。24例患者（89%）使用了戈特分流管，1例患者（4%）使用了部分股-股旁路进行远端灌注。2例患者（7%）采用了钳夹缝合技术。
结果
通过戈特分流管进行远端灌注的患者，平均主动脉阻断时间为44±3分钟（范围为22至80分钟）。1例患者（4%）在主动脉修复术后30天内死于多系统器官衰竭。1例患者（4%）发生截瘫。
结论
采用规范的诊断和手术方法治疗胸降主动脉创伤性破裂患者，有可能取得良好的治疗效果。在创伤性主动脉破裂修复过程中，使用戈特分流管是一种简单有效的远端灌注方法。
Zotero 插件