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改良主动脉弓置换加支架象鼻手术治疗StanfordA型动脉夹层 被引量:2

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摘要 目的:总结改良主动脉弓置换加支架象鼻手术治疗 Stanford A 型主动脉夹层的临床经验。方法选择主动脉夹层 Stanford A 型(无名动脉和左颈总动脉未受累及)患者17例。急诊手术13例,择期手术4例,其中3例行升主动脉人工血管置换和三分支支架血管置入术,14例行保留头臂血管的主动脉弓内岛状吻合术。结果住院期间死亡2例,死亡原因为脑水肿并发多器官功能衰竭及纵膈感染致感染性休克。体外循环时间(227±39)min,升主动脉阻断时间(79±15)min,选择性脑灌注时间(39±6)min;术后24 h 胸引流量(649±230) mL,无再次开胸止血病例,术后 ICU 停留时间(73±18)h。术后出现急性肾功能衰竭2例,急性肝功能重度损害1例。除死亡2例外余病例均治愈出院。术后随诊1~16个月,1例在外院因肺部感染死亡,其他病例恢复良好,无因夹层进展需二次手术。结论改良主动脉弓置换加支架象鼻手术是治疗弓部三分支血管无破口的 Stanford A型主动脉夹层安全、有效的方法,具有简化手术过程,容易控制出血,简单易于推广的优点。
出处 《广东医学》 CAS CSCD 北大核心 2014年第11期1715-1717,共3页 Guangdong Medical Journal
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参考文献9

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