胸主动脉夹层动脉瘤的外科治疗

SURGICAL MANAGEMENT OF THORACIC AORTIC DISSECTING ANEURYSM

①目的 探讨胸主动脉夹层动脉瘤的外科治疗方法。②方法 胸主动脉夹层动脉瘤１０ 例，行 Ｂｅｎｔａｌｌ手术 ６ 例，升主动脉及主动脉弓半弓置换术２ 例，胸降主动脉置换术２ 例。术中选择股动脉插管，对剥离内膜进行了可靠修复；对 Ｂｅｎｔａｌｌ术中冠状动脉移植技术进行了改进；在主动脉弓置换时，对脑采取保护措施以减轻或防止脑损害。③结果 手术死亡１ 例，术后近期死亡２ 例，７ 例术后随访９０ｄ～１．５ 年，康复良好。④结论 手术治疗胸主动脉夹层动脉瘤效果良好。

Objective\ To summarize the experience in surgical treatment of thoracic aortic dissecting aneurysm.\ Methods\ 10 patients with thoracic aortic dessecting aneurysm underwent surgical treatment. Surgical operation proformed included Bentall operation in 6, replacement of ascending aorta and partial aortic arch in 2, replacement of thoracic descending aorta in 2. Femoral artery was selected for cannulation in operation. Reliable repairment of stripped endoarterium was done and coronary artery grafting technique was improved in Bentall's operation; When replacing aortic arch, appropriate brain protection could release or prevent cerebral lesion.\ Results\ One patient died during operation, two died soon after operation, and the others recovered unevently within the follow up time of 90 days to 1.5 years.\ Conclusion\ Early diagnosis and early operation were very important for the prognosis of patients with thoracic aortic dissecting aneurysm.\;