Bentall术应用于治疗升主动脉瘤的疗效分析

Bentall procedure for ascending aortic aneurysm

目的 探讨Bentall术治疗升主动脉瘤的临床疗效。方法 选择2015年2月至2018年2月期间在本院行Bentall术治疗的14例升主动脉瘤患者。术后观察两组患者术中及术后恢复相关指标,监测患者并发症及死亡,并对比患者术前和术后3个月左心室射血分数(LVEF)和左心室舒张末期内径(LVEDD)指标变化。结果 14例患者均顺利完成Bentall术,术后心功能均明显改善,术后3个月复查显示患者心功能均达到Ⅱ级以上。本组患者术后均无死亡者。患者术后并发症均治疗成功,无透析者。术后3个月患者LVEDD较术前[(45.13±5.03)mm比(61.23±12.03)mm]显著缩短,差异有统计学意义(P<0.05);患者LVEF较术前[(47.23±7.03)%比(36.58±5.13)%]显著提高,差异有统计学意义(P<0.05)。结论 升主动脉瘤应用Bentall术治疗,可同时矫治瓣膜及血管病变,临床疗效可靠,但应注意做好并发症处理,以改善患者预后。

Objective To investigate the clinical effect of Bentall operation on ascending aortic aneurysm.Methods From February 2015 to February 2018,14 patients with ascending aortic aneurysm underwent Bentall operation in our hospital.Relevant indexes of recovery during and after the operation were observed,the complications and death were monitored,and changes of left ventricular ejection fraction(LVEF)and left ventricular end-diastolic diameter(LVEDD)were compared before and 3 months after the operation.Results Bentall operation was successfully completed in all 14 patients.Cardiac function improved significantly after the operation.Three months after the operation,cardiac function of all patients reached grade II or above.None of the patients died after the operation.Postoperative complications were successfully treated without dialysis.Three months after the operation,the patients'LVEDD[(45.13±5.03)mm]was significantly less than that before the operation[(61.23±12.03)mm](P<0.05),the patients'LVEF[(47.23±7.03)%]was significantly higher than that before the operation[(36.58±5.13)%](P<0.05).Conclusion Bentall operation for ascending aortic aneurysm can correct both valvular and vascular lesions,with reliable clinical effect,but attention should be paid to the treatment on complications in order to improve the prognosis of patients.