Tayama K, Akashi H, Okazaki T, Fujino T, Kai E, Hanamoto Y, Ishihara K, Tanaka A, Kawara T, Aoyagi S
Department of Surgery, Kurume University School of Medicine, Japan.
Kyobu Geka. 1997 Jul;50(8 Suppl):637-40.
A consecutive series of 16 patients over 75 years old who underwent aortic arch operations with hypothermic selective cerebral perfusion from 1994 to 1997 was analyzed. These patients (group O) was compared with 18 patients aged from 70 to 74-year-old (group M) and 38 patients under the age of 69 (group Y) who underwent aortic arch operation during the same period. There were 5 males and 11 females with a mean age of 77.8 years (range 75 to 86) in group O. Twelve patients were in aortic dissection and 4 patients were in atherosclerotic aneurysms. There were 5 hospital deaths (31.2%) in group O, 2 (11.1%) in group M and 2 (5.3%) in group Y. There was significant difference in hospital mortality rate between group O and group Y. Cerebral complication occurred in 2 patients (12.5%) and postoperative respiratory failure occurred in 7 (47%) in group O. Aortic arch operations for the elderly patients can be performed with increased but operative mortality in the elderly patients remains high. In this study, we discussed that influence of risk factors on the operative result and operative indication in the elderly patients.
分析了1994年至1997年间连续16例75岁以上接受主动脉弓手术并采用低温选择性脑灌注的患者。将这些患者（O组）与同期接受主动脉弓手术的18例70至74岁患者（M组）和38例69岁以下患者（Y组）进行比较。O组有5名男性和11名女性，平均年龄77.8岁（范围75至86岁）。12例患者为主动脉夹层，4例患者为动脉粥样硬化性动脉瘤。O组有5例医院死亡（31.2%），M组2例（11.1%），Y组2例（5.3%）。O组和Y组的医院死亡率有显著差异。O组有2例（12.5%）发生脑并发症，7例（47%）发生术后呼吸衰竭。老年患者的主动脉弓手术可以进行，但老年患者的手术死亡率仍然很高。在本研究中，我们讨论了危险因素对老年患者手术结果和手术指征的影响。
