摘要
目的探讨晚期妊娠合并急性A型主动脉夹层的多学科诊疗管控。方法回顾性分析陆军军医大学第二附属医院2018~2019年收治的3例晚期妊娠合并急性A型主动脉夹层患者的临床资料,年龄27~32岁,孕周34~37周。突发胸骨后疼痛是术前的主要临床症状。3例患者均在全身麻醉下行剖宫产后再行Bentall手术,其中2例加行全主动脉弓置换+支架象鼻术,1例加行冠状动脉旁路移植术。结果围手术期无死亡病例,新生儿均顺利娩出并健康存活。术后ICU停留时间3~5 d,术后住院时间为15~18 d。随访时间250~751 d,无复发、死亡患者。1例出现自发性气胸和液气胸,于我中心治愈出院。结论多学科联合诊疗策略对于挽救晚期妊娠合并A型主动脉夹层患者的生命至关重要。
Objective To investigate the multidisciplinary management of patients with acute type A aortic dissection in late pregnancy. Methods The clinical data of 3 patients admitted to the Second Affiliated Hospital of Army Medical University from 2018 to 2019 were analyzed. Their age ranged from 27 to 32 years, while gestational age was 34-37 weeks. Sudden chest pain was the main clinical symptom before operation. All 3 patients underwent Bentall surgery after cesarean section under general anesthesia, of whom 2 patients received total arch replacement(TAR) combined with frozen elephant trunk(FET) implantation and 1 received coronary artery bypass grafting(CABG) additionally.Results No patient died during the perioperative period, and all the newborns were delivered successfully and survived healthily. The ICU stay was 3-5 d. The postoperative hospital stay was 15-18 d. The follow-up was 250-751 d. There was no recurrence or death. One patient who developed spontaneous pneumothorax and hydropneumothorax was cured in our center. Conclusion The multidisciplinary diagnosis and treatment strategy plays a crucial role in saving the life of pregnant patients with acute type A aortic dissection.
作者
刘凌超
李畑波
刘宸铖
徐博
肖颖彬
王咏
LIU Lingchao;LI Tianbo;LIU Chencheng;XU Bo;XIAO Yingbin;WANG Yong(Institute of Cardiovascular Surgery,Xinqiao Hospital,Army Medical University,Chongqing,400037,P.R.China)
出处
《中国胸心血管外科临床杂志》
CSCD
北大核心
2021年第12期1488-1493,共6页
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
基金
陆军军医大学临床技术创新培育项目(CX2019JS216)。
关键词
主动脉夹层
妊娠
多学科
治疗
Aortic dissection
pregnancy
multiple disciplines
treatment