急性主动脉夹层合并下肢缺血的外科治疗效果

Surgical treatment of aortic dissection with lower extremity ischemia

目的探讨StanfordA型急性主动脉夹层合并下肢缺血的外科治疗效果。方法回顾性分析2009年3月至2013年4月首都医科大学附属北京安贞医院心脏外科中心14例合并下肢缺血的急性A型主动脉夹层患者资料，14例患者均接受孙氏手术治疗，并同期行升主动脉-髂动脉转流、升主动脉一股动脉转流、股动脉．股动脉转流或腋动脉一股动脉转流手术。结果术后患者死亡2例，死亡原因均为并发多器官功能障碍综合征。其余患者术后均顺利康复出院，下肢缺血症状消失或改善，术后平均随访24个月，患者无主动脉相关并发症发生。结论对于合并下肢缺血的A型主动脉夹层患者，积极行股动脉转流术，有助于降低手术死亡发生率，提高生存率和术后生活质量。

Objective To explore the clinical outcome of the surgical treatment for aortic dissection with lower extremity ischemia. Methods Between March 2009 and April 2013, 14 patients with type A aortic dissection and lower extremity ischemia underwent Sun＇s procedure in Beijing Anzhen Hospital. Ascending aorta-iliac artery bypass, ascending aorta-femoral artery bypass, femoral-femoral artery bypass and axillary -femoral artery bypass were performed on some severe patients at the same time. Results Two death occurred, and the others were improved or recovered from symptoms. Follow-up was complete with an average time of 24 months and no aortic relevant complications occurred. Conclusion As for patients with type A aortic dissection and lower extremity ischemia, simuhaneous radical femoral artery bypass procedure is effective in imoroving their survival rate and auality of life.