柳州市市级医院开展Bentall手术的经验体会

The surgical treatment experience of Bentall procedure in municipal hospitals in Liuzhou

目的总结柳州市市级医院Bentall手术治疗的经验,探讨影响市级医院Bentall手术早期疗效的有关因素。方法回顾性分析2005-01-2014-12柳州市市级医院行Bentall手术治疗的28例患者的临床资料。结果术后早期死亡6例（21.43%）,死于低心排血量综合征2例,呼吸功能不全、肺部感染引起的多器官功能衰竭3例,慢性心力衰竭1例。呼吸功能不全及肺部感染是术后常见并发症,发生率高。出院22例患者均获随访,1例术后2个月大面积脑梗死,1例于手术后6年患肺癌死亡,其余患者心功能明显改善。结论柳州市市级医院开展Bentall手术总体效果满意,手术后早期病死率及急性呼吸功能不全发生率偏高与收治病种以急性主动脉夹层为主有一定关系,提高手术操作水平,缩短体外循环尤其是主动脉阻断时间,积极防治术后并发症,是提高市级医院Bentall手术疗效的关键。

Objective To summarise thesurgical treatment experience of Bentall procedure in municipalhosjDitals in Liuzhou and to explore the influencing factors on the early efficacy of Bentallclinical data were retrospectively analyzed in 28 patients who underwent the Bentall procedures from January 2005 toDecember 2014 in municipal hospitals in Liuzhou. Results During the early stage after Bentall procedure,3 casesdied of multiple systems organ failure from pulmonary infections and respiratory insufficiency,2 cases cardiac output symptom,1 case died of chronic heart failure. The total mortality in early stage after Bentall procedure was 21. 43% ,among which pulmonary infections and respiratory insufficiency were the major complications. Duringthe follow-up period,1 case died of lung cancer,1 case suffered from large area cerebral infarction and a significant improvement of cardiac function after Bentall procedure. Conclusion Bentall procedure providesurvival for the patients in municipal hospitals in Liuzhou. The relatively higher early mortality may be related to theacute aortic dissection. Improving the surgical skills, reducing the extracorporeal circulation duration, especially after aorta block, and actively preventing the complications after surgery are the key steps to improve the clinical outcomes.