升主动脉成形术的早中期临床结果分析

目的分析升主动脉成形术治疗主动脉瓣病变伴升主动脉扩张患者的临床随访结果,总结其临床经验,以提高治疗效果。方法回顾性分析2002年1月至2010年8月北京阜外心血管病医院36例主动脉瓣病变伴升主动脉扩张患者行主动脉瓣置换和升主动脉成形术的临床资料,其中男26例、女10例,年龄7~72（51±16）岁。分别于术前、术后出院前及随访中通过心脏超声心动图检查测量升主动脉直径,并进行比较。结果无围术期死亡。体外循环时间（96.2±28.3）min,主动脉阻断时间（69.2±22.1）min,术后住院时间（11.0±7.8）d。36例患者全部进行随访,术后随访1.1~9.0（4.0±2.3）年,随访期间死亡1例,无二次手术患者。心脏超声心动图提示：主动脉瓣功能正常,术后升主动脉直径较术前减小[（36.4±6.1）mm vs.（46.8±4.6）mm,t=13.12,P=0.00];随访期间升主动脉直径与术后相比有所增加[（40.8±6.8）mm vs.（36.4±6.1）mm,t=-2.64,P=0.01],与术前相比减小[（40.8±6.8）mm vs.（46.8±4.6）mm,t=3.48,P=0.00]。结论升主动脉成形术治疗主动脉瓣病变伴升主动脉扩张患者可获得较好的早中期疗效,但远期效果需进一步随访观察。     

无包裹-纵切口升主动脉成形术治疗升主动脉扩张的疗效分析

目的探讨无包裹-纵切口升主动脉成形术治疗升主动脉扩张的临床疗效。方法 2005年9月-2011年5月,对53例主动脉瓣病变伴升主动脉扩张患者行主动脉瓣置换加无包裹-纵切口升主动脉成形术治疗。男41例,女12例;年龄22～75岁,平均52岁。病程1个月～14年。心脏彩色超声多普勒检查示术前升主动脉直径为(45.9±3.3)mm;主动脉瓣三叶瓣40例,主动脉瓣二叶畸形13例。心功能根据纽约心脏病协会(NYHA)分级标准:Ⅱ级19例,Ⅲ级33例,Ⅳ级1例。结果术后发生1例纵隔广泛渗血、3例肺部感染、1例Ⅲ度房室传导阻滞。患者均无升主动脉成形术相关并发症。53例均获随访,随访时间3～68个月,平均15个月。患者均无明显胸闷、心累。末次随访时心功能NYHA分级Ⅰ级22例,Ⅱ级31例。升主动脉直径为(35.2±4.0)mm,与术前比较差异有统计学意义(P=0.000);与术后出院时(34.0±2.5)mm比较差异无统计学意义(P=0.245)。其中,随访时间≥60个月者末次随访时升主动脉直径与术前、术后出院时比较,差异均有统计学意义(P<0.05);主动脉瓣二叶畸形患者末次随访时升主动脉直径与术前比较差异有统计学意义(P<0.05);术前升主动脉直径>50 mm患者末次随访时升主动脉直径与术前比较,差异无统计学意义(P>0.05)。结论无包裹-纵切口升主动脉成形术治疗主动脉瓣病变伴升主动脉轻-中度(直径范围40～50 mm)扩张患者可获得较好早中期疗效,但应严格选择患者,远期效果需进一步随访观察。     

升主动脉成形术中期效果分析

目的 分析升主动脉成形术治疗主动脉瓣病变伴升主动脉扩张病人的中期随访结果并总结其临床经验.方法 1996年10月至2007年4月对54例主动脉瓣病变伴升主动脉扩张的病人行主动脉瓣膜置换和升主动脉成形术,术后随访13～96个月,平均(23±16)个月.分别于术前、出院前及术后随访中,通过心脏超声检查测量升主动脉直径.结果 围术期死亡2例.术前升主动脉直径(45.77±6.02)mm与出院前升主动脉直径(34.67±4.81)mm二者比较差异有统计学意义(P<0.01).术后随访升主动脉直径(37.65±6.35)砌与术前及术后出院前比较差异亦均有统计学意义(P<0.01).单纯主动脉瓣狭窄的基础病变和术后出院前升主动脉直径大于40mm是升主动脉再扩张的独立风险因素.结论 升主动脉成形术中未用人工血管包裹治疗主动脉瓣病变伴升主动脉扩张或者升主动脉瘤的中期疗效欠佳.单纯主动脉瓣狭窄是这种术式的适应证,成形术必须将主动脉直径减至40mm以下,以减少远期再扩张.     

升主动脉成形术中期效果分析

Objective Reduction ascending aortoplasty is an alternative procdure to the replacement of the ascending aorts in case of ascending aorta dilation. However,its applicabikity is still under debate.This retrospective study was designed to evaluuate the midterm follow-up of unsupported ascending reduction aortoplasty for of the ascending aorta in petients with aortic valve dis- ease.Methods From October ,1996 to April,2007, a total of 54 patients with aortic valve disease and dilatation of the ascending aorta underwent unsupported reduction aortoplasty in combination with aortic valve replacement at our institution The diameter of the ascending aorta was measyred before and early after sugery and then later between 13 and 96 menths [mean (23 ±16)months] posto- perativeiy using echocardiography.Results Two patients were dead with thean overall perioperative mortality rate was of 3.7%. The reduction aortoplasty decreased the diameter of the aorta from (45.77±6.02) mm p～eope～afive]y to (34.67 ～4.81) mm early after surgery (P<0.01). During follow-up, the diameter d aorta increased from (34.67±4.81) mm early after surgery to (37.65± 6.35) mm after a mean follow-up of (23±16) months (P<0.01), including the diameters are greater than > 45 mm within 5 pa- tients. Aortic stenosis and an early postoperative diameter greater than 40 mm m'e independent risk factors for redilatation. Conchusion Because of the unsatisfied midterm follow-up redilation of unsupported reduction aortoplasty for dilation of the ascending aorta with aortic valve disease, this group of patients needs continued intimate fallow-up or even reoperation. The patients of stenosis is the surtable indication for RAA, and it is necessary to reduce the diameter of aorta to be lees than 40 mm to prevent redilation.     

升主动脉成形术中期效果分析

Objective Reduction ascending aortoplasty is an alternative procdure to the replacement of the ascending aorts in case of ascending aorta dilation. However,its applicabikity is still under debate.This retrospective study was designed to evaluuate the midterm follow-up of unsupported ascending reduction aortoplasty for of the ascending aorta in petients with aortic valve dis- ease.Methods From October ,1996 to April,2007, a total of 54 patients with aortic valve disease and dilatation of the ascending aorta underwent unsupported reduction aortoplasty in combination with aortic valve replacement at our institution The diameter of the ascending aorta was measyred before and early after sugery and then later between 13 and 96 menths [mean (23 ±16)months] posto- perativeiy using echocardiography.Results Two patients were dead with thean overall perioperative mortality rate was of 3.7%. The reduction aortoplasty decreased the diameter of the aorta from (45.77±6.02) mm p～eope～afive]y to (34.67 ～4.81) mm early after surgery (P<0.01). During follow-up, the diameter d aorta increased from (34.67±4.81) mm early after surgery to (37.65± 6.35) mm after a mean follow-up of (23±16) months (P<0.01), including the diameters are greater than > 45 mm within 5 pa- tients. Aortic stenosis and an early postoperative diameter greater than 40 mm m'e independent risk factors for redilatation. Conchusion Because of the unsatisfied midterm follow-up redilation of unsupported reduction aortoplasty for dilation of the ascending aorta with aortic valve disease, this group of patients needs continued intimate fallow-up or even reoperation. The patients of stenosis is the surtable indication for RAA, and it is necessary to reduce the diameter of aorta to be lees than 40 mm to prevent redilation.     

升主动脉成形术中期效果分析

Objective Reduction ascending aortoplasty is an alternative procdure to the replacement of the ascending aorts in case of ascending aorta dilation. However,its applicabikity is still under debate.This retrospective study was designed to evaluuate the midterm follow-up of unsupported ascending reduction aortoplasty for of the ascending aorta in petients with aortic valve dis- ease.Methods From October ,1996 to April,2007, a total of 54 patients with aortic valve disease and dilatation of the ascending aorta underwent unsupported reduction aortoplasty in combination with aortic valve replacement at our institution The diameter of the ascending aorta was measyred before and early after sugery and then later between 13 and 96 menths [mean (23 ±16)months] posto- perativeiy using echocardiography.Results Two patients were dead with thean overall perioperative mortality rate was of 3.7%. The reduction aortoplasty decreased the diameter of the aorta from (45.77±6.02) mm p～eope～afive]y to (34.67 ～4.81) mm early after surgery (P<0.01). During follow-up, the diameter d aorta increased from (34.67±4.81) mm early after surgery to (37.65± 6.35) mm after a mean follow-up of (23±16) months (P<0.01), including the diameters are greater than > 45 mm within 5 pa- tients. Aortic stenosis and an early postoperative diameter greater than 40 mm m'e independent risk factors for redilatation. Conchusion Because of the unsatisfied midterm follow-up redilation of unsupported reduction aortoplasty for dilation of the ascending aorta with aortic valve disease, this group of patients needs continued intimate fallow-up or even reoperation. The patients of stenosis is the surtable indication for RAA, and it is necessary to reduce the diameter of aorta to be lees than 40 mm to prevent redilation.     

升主动脉成形术中期效果分析

Objective Reduction ascending aortoplasty is an alternative procdure to the replacement of the ascending aorts in case of ascending aorta dilation. However,its applicabikity is still under debate.This retrospective study was designed to evaluuate the midterm follow-up of unsupported ascending reduction aortoplasty for of the ascending aorta in petients with aortic valve dis- ease.Methods From October ,1996 to April,2007, a total of 54 patients with aortic valve disease and dilatation of the ascending aorta underwent unsupported reduction aortoplasty in combination with aortic valve replacement at our institution The diameter of the ascending aorta was measyred before and early after sugery and then later between 13 and 96 menths [mean (23 ±16)months] posto- perativeiy using echocardiography.Results Two patients were dead with thean overall perioperative mortality rate was of 3.7%. The reduction aortoplasty decreased the diameter of the aorta from (45.77±6.02) mm p～eope～afive]y to (34.67 ～4.81) mm early after surgery (P<0.01). During follow-up, the diameter d aorta increased from (34.67±4.81) mm early after surgery to (37.65± 6.35) mm after a mean follow-up of (23±16) months (P<0.01), including the diameters are greater than > 45 mm within 5 pa- tients. Aortic stenosis and an early postoperative diameter greater than 40 mm m'e independent risk factors for redilatation. Conchusion Because of the unsatisfied midterm follow-up redilation of unsupported reduction aortoplasty for dilation of the ascending aorta with aortic valve disease, this group of patients needs continued intimate fallow-up or even reoperation. The patients of stenosis is the surtable indication for RAA, and it is necessary to reduce the diameter of aorta to be lees than 40 mm to prevent redilation.     

升主动脉成形术中期效果分析

Objective Reduction ascending aortoplasty is an alternative procdure to the replacement of the ascending aorts in case of ascending aorta dilation. However,its applicabikity is still under debate.This retrospective study was designed to evaluuate the midterm follow-up of unsupported ascending reduction aortoplasty for of the ascending aorta in petients with aortic valve dis- ease.Methods From October ,1996 to April,2007, a total of 54 patients with aortic valve disease and dilatation of the ascending aorta underwent unsupported reduction aortoplasty in combination with aortic valve replacement at our institution The diameter of the ascending aorta was measyred before and early after sugery and then later between 13 and 96 menths [mean (23 ±16)months] posto- perativeiy using echocardiography.Results Two patients were dead with thean overall perioperative mortality rate was of 3.7%. The reduction aortoplasty decreased the diameter of the aorta from (45.77±6.02) mm p～eope～afive]y to (34.67 ～4.81) mm early after surgery (P<0.01). During follow-up, the diameter d aorta increased from (34.67±4.81) mm early after surgery to (37.65± 6.35) mm after a mean follow-up of (23±16) months (P<0.01), including the diameters are greater than > 45 mm within 5 pa- tients. Aortic stenosis and an early postoperative diameter greater than 40 mm m'e independent risk factors for redilatation. Conchusion Because of the unsatisfied midterm follow-up redilation of unsupported reduction aortoplasty for dilation of the ascending aorta with aortic valve disease, this group of patients needs continued intimate fallow-up or even reoperation. The patients of stenosis is the surtable indication for RAA, and it is necessary to reduce the diameter of aorta to be lees than 40 mm to prevent redilation.     

升主动脉成形术中期效果分析

Objective Reduction ascending aortoplasty is an alternative procdure to the replacement of the ascending aorts in case of ascending aorta dilation. However,its applicabikity is still under debate.This retrospective study was designed to evaluuate the midterm follow-up of unsupported ascending reduction aortoplasty for of the ascending aorta in petients with aortic valve dis- ease.Methods From October ,1996 to April,2007, a total of 54 patients with aortic valve disease and dilatation of the ascending aorta underwent unsupported reduction aortoplasty in combination with aortic valve replacement at our institution The diameter of the ascending aorta was measyred before and early after sugery and then later between 13 and 96 menths [mean (23 ±16)months] posto- perativeiy using echocardiography.Results Two patients were dead with thean overall perioperative mortality rate was of 3.7%. The reduction aortoplasty decreased the diameter of the aorta from (45.77±6.02) mm p～eope～afive]y to (34.67 ～4.81) mm early after surgery (P<0.01). During follow-up, the diameter d aorta increased from (34.67±4.81) mm early after surgery to (37.65± 6.35) mm after a mean follow-up of (23±16) months (P<0.01), including the diameters are greater than > 45 mm within 5 pa- tients. Aortic stenosis and an early postoperative diameter greater than 40 mm m'e independent risk factors for redilatation. Conchusion Because of the unsatisfied midterm follow-up redilation of unsupported reduction aortoplasty for dilation of the ascending aorta with aortic valve disease, this group of patients needs continued intimate fallow-up or even reoperation. The patients of stenosis is the surtable indication for RAA, and it is necessary to reduce the diameter of aorta to be lees than 40 mm to prevent redilation.     

升主动脉成形术中期效果分析

Objective Reduction ascending aortoplasty is an alternative procdure to the replacement of the ascending aorts in case of ascending aorta dilation. However,its applicabikity is still under debate.This retrospective study was designed to evaluuate the midterm follow-up of unsupported ascending reduction aortoplasty for of the ascending aorta in petients with aortic valve dis- ease.Methods From October ,1996 to April,2007, a total of 54 patients with aortic valve disease and dilatation of the ascending aorta underwent unsupported reduction aortoplasty in combination with aortic valve replacement at our institution The diameter of the ascending aorta was measyred before and early after sugery and then later between 13 and 96 menths [mean (23 ±16)months] posto- perativeiy using echocardiography.Results Two patients were dead with thean overall perioperative mortality rate was of 3.7%. The reduction aortoplasty decreased the diameter of the aorta from (45.77±6.02) mm p～eope～afive]y to (34.67 ～4.81) mm early after surgery (P<0.01). During follow-up, the diameter d aorta increased from (34.67±4.81) mm early after surgery to (37.65± 6.35) mm after a mean follow-up of (23±16) months (P<0.01), including the diameters are greater than > 45 mm within 5 pa- tients. Aortic stenosis and an early postoperative diameter greater than 40 mm m'e independent risk factors for redilatation. Conchusion Because of the unsatisfied midterm follow-up redilation of unsupported reduction aortoplasty for dilation of the ascending aorta with aortic valve disease, this group of patients needs continued intimate fallow-up or even reoperation. The patients of stenosis is the surtable indication for RAA, and it is necessary to reduce the diameter of aorta to be lees than 40 mm to prevent redilation.     

升主动脉成形术中期效果分析

Objective Reduction ascending aortoplasty is an alternative procdure to the replacement of the ascending aorts in case of ascending aorta dilation. However,its applicabikity is still under debate.This retrospective study was designed to evaluuate the midterm follow-up of unsupported ascending reduction aortoplasty for of the ascending aorta in petients with aortic valve dis- ease.Methods From October ,1996 to April,2007, a total of 54 patients with aortic valve disease and dilatation of the ascending aorta underwent unsupported reduction aortoplasty in combination with aortic valve replacement at our institution The diameter of the ascending aorta was measyred before and early after sugery and then later between 13 and 96 menths [mean (23 ±16)months] posto- perativeiy using echocardiography.Results Two patients were dead with thean overall perioperative mortality rate was of 3.7%. The reduction aortoplasty decreased the diameter of the aorta from (45.77±6.02) mm p～eope～afive]y to (34.67 ～4.81) mm early after surgery (P<0.01). During follow-up, the diameter d aorta increased from (34.67±4.81) mm early after surgery to (37.65± 6.35) mm after a mean follow-up of (23±16) months (P<0.01), including the diameters are greater than > 45 mm within 5 pa- tients. Aortic stenosis and an early postoperative diameter greater than 40 mm m'e independent risk factors for redilatation. Conchusion Because of the unsatisfied midterm follow-up redilation of unsupported reduction aortoplasty for dilation of the ascending aorta with aortic valve disease, this group of patients needs continued intimate fallow-up or even reoperation. The patients of stenosis is the surtable indication for RAA, and it is necessary to reduce the diameter of aorta to be lees than 40 mm to prevent redilation.     

升主动脉成形术中期效果分析

Objective Reduction ascending aortoplasty is an alternative procdure to the replacement of the ascending aorts in case of ascending aorta dilation. However,its applicabikity is still under debate.This retrospective study was designed to evaluuate the midterm follow-up of unsupported ascending reduction aortoplasty for of the ascending aorta in petients with aortic valve dis- ease.Methods From October ,1996 to April,2007, a total of 54 patients with aortic valve disease and dilatation of the ascending aorta underwent unsupported reduction aortoplasty in combination with aortic valve replacement at our institution The diameter of the ascending aorta was measyred before and early after sugery and then later between 13 and 96 menths [mean (23 ±16)months] posto- perativeiy using echocardiography.Results Two patients were dead with thean overall perioperative mortality rate was of 3.7%. The reduction aortoplasty decreased the diameter of the aorta from (45.77±6.02) mm p～eope～afive]y to (34.67 ～4.81) mm early after surgery (P<0.01). During follow-up, the diameter d aorta increased from (34.67±4.81) mm early after surgery to (37.65± 6.35) mm after a mean follow-up of (23±16) months (P<0.01), including the diameters are greater than > 45 mm within 5 pa- tients. Aortic stenosis and an early postoperative diameter greater than 40 mm m'e independent risk factors for redilatation. Conchusion Because of the unsatisfied midterm follow-up redilation of unsupported reduction aortoplasty for dilation of the ascending aorta with aortic valve disease, this group of patients needs continued intimate fallow-up or even reoperation. The patients of stenosis is the surtable indication for RAA, and it is necessary to reduce the diameter of aorta to be lees than 40 mm to prevent redilation.     

升主动脉成形术中期效果分析

Objective Reduction ascending aortoplasty is an alternative procdure to the replacement of the ascending aorts in case of ascending aorta dilation. However,its applicabikity is still under debate.This retrospective study was designed to evaluuate the midterm follow-up of unsupported ascending reduction aortoplasty for of the ascending aorta in petients with aortic valve dis- ease.Methods From October ,1996 to April,2007, a total of 54 patients with aortic valve disease and dilatation of the ascending aorta underwent unsupported reduction aortoplasty in combination with aortic valve replacement at our institution The diameter of the ascending aorta was measyred before and early after sugery and then later between 13 and 96 menths [mean (23 ±16)months] posto- perativeiy using echocardiography.Results Two patients were dead with thean overall perioperative mortality rate was of 3.7%. The reduction aortoplasty decreased the diameter of the aorta from (45.77±6.02) mm p～eope～afive]y to (34.67 ～4.81) mm early after surgery (P<0.01). During follow-up, the diameter d aorta increased from (34.67±4.81) mm early after surgery to (37.65± 6.35) mm after a mean follow-up of (23±16) months (P<0.01), including the diameters are greater than > 45 mm within 5 pa- tients. Aortic stenosis and an early postoperative diameter greater than 40 mm m'e independent risk factors for redilatation. Conchusion Because of the unsatisfied midterm follow-up redilation of unsupported reduction aortoplasty for dilation of the ascending aorta with aortic valve disease, this group of patients needs continued intimate fallow-up or even reoperation. The patients of stenosis is the surtable indication for RAA, and it is necessary to reduce the diameter of aorta to be lees than 40 mm to prevent redilation.     

主动脉成形术治疗主动脉瓣病变伴升主动脉扩张的疗效分析

目的总结主动脉成形术治疗主动脉瓣病变伴升主动脉扩张患者的临床经验及疗效。方法1998年2月至2004年5月共对23例主动脉瓣病变伴升主动脉扩张的患者行主动脉瓣膜置换和纵行切除部分升主动脉壁的主动脉成形术,术后随访4～78个月,平均(36±25)个月,分别于术前、术后出院前及术后随访中,通过心脏超声检查测量主动脉直径。结果主动脉直径术前为(4.8±0.5)cm,术后出院前为(3.6±0.4)cm,两者比较差异有统计学意义(P<0.01)。术后随访中,主动脉直径为(3.7±0.4)cm,与术前比较差异有统计学意义(P<0.01),与术后出院前比较差异无统计学意义(P>0.05)。结论应用切除部分升主动脉壁的主动脉成形术治疗主动脉瓣病变伴升主动脉扩张或升主动脉瘤,中期疗效良好。     

主动脉窦成形术修复急性Stanford A型主动脉夹层受累根部的近期效果

目的 探索主动脉窦成形在修复急性StanfordA型主动脉夹层受累根部中的可行性、有效性和效果的持久性.方法 从2014年1月至2017年7月,共43例急性StanfordA型主动脉夹层患者在我院接受了主动脉窦成形术修复受累的主动脉根部,其中男34例、女9例,年龄32～65(50.1±8.1)岁.回顾性分析患者的围术期...     

升主动脉置换术或成形术治疗主动脉瓣病变合并的升主动脉瘤样扩张

目的 对比分析主动脉瓣病变合并升主动脉瘤扩张在行主动脉瓣置换术(AVR)的同时施行升主动脉置换术(A组)或成形术(B组)的结果,探讨两种方法的临床效果及适应证.方法 A、B两组术前年龄、性别、心功能分级、主动脉瓣病变、左室射血分数等差异均无统计学意义.A组主动脉直径(49.45±3.96)mm,B组(49.31±3.68)mm,差异亦无统计学意义.行AVR后A组常规置换升主动脉,B组纵行切除部分升主动脉壁,缝合后包裹28～30 mm人工血管.结果 A、B两组术后均无死亡.A组主动脉阻断(71.70±17.13)min、体外循环(110.52±27.51)min,均明显大于B组的(57.13±16.32)min(P=0.025)和(97.31±19.46)min(P=0.004).两组术中及术后输血量、并发症发生率差异无统计学意义.结论 主动脉瓣病变合并升主动脉瘤样扩张,年轻病人主动脉直径≥40 mm时应积极手术处理扩张的升主动脉.升主动脉成形术,同时外包裹人工血管的方法较升主动脉置换术更为简单、安全,但升主动脉壁必须无粥样硬化或溃疡.     

Taussig-Bing畸形患儿动脉调转术后中远期主动脉根部结局的单中心回顾性研究

目的 探究接受动脉调转术后的Taussig-Bing畸形患儿中远期主动脉根部生长情况以及新主动脉瓣反流情况。方法 回顾性纳入2002—2017年于上海儿童医学中心接受动脉调转术治疗早期存活且随访时间>3年的患儿,收集随访超声数据并进行分析。结果 共纳入127例患者,其中男98例（77.2%）,中位手术年龄73.0 d,平均体重4.7 kg,术前45例（35.4%）患儿合并轻度至轻中度肺动脉瓣反流。平均随访时间7.0年。随访中14例（11.0%）患儿出现中度及以上新主动脉瓣反流,3例接受新主动脉瓣机械瓣置换。新主动脉瓣环及窦部内径在随访过程中始终大于同龄患儿正常水平,随访5年平均瓣环内径18.0 mm,随访10年20.5 mm。随访5年窦部内径25.9 mm,随访10年31.1 mm。新主动脉瓣反流随年龄增长逐渐发展。随访过程中出现新主动脉瓣中度及以上反流的患儿其瓣环直径始终大于未出现中度及以上反流的患儿（χ2=18.3,P<0.001）。术前肺动脉瓣轻度及轻中度反流增加中远期新主动脉瓣中度及以上反流的风险（c-HR=3.46,P=0.03）。结论 接受动脉调转术的Tauss...     

右前胸第二肋间小切口升主动脉手术的单中心分析

目的 评估右前胸第2肋间小切口升主动脉手术的可行性、安全性和近期疗效.方法 回顾性分析2019年10月至2020年9月在我中心实施的13例右前胸第2肋间小切口升主动脉手术(Bentall 7例、Wheat 2例、升主动脉置换4例)患者的临床资料.男12例、女1例,年龄(52.4土13.7)岁.结果 主动脉阻断时间(84...     

主动脉瓣及瓣上狭窄合并升主动脉扩张一例

患者男,29岁。主诉：发现心脏杂音13年,心前区痛1周余。查体：血压120/80 mm Hg,心率70次/分,律齐,主动脉瓣听诊区可闻及3/6级收缩期喷射样杂音,向颈部传导,P2〉A2。心电图示：窦性心律,左心室高电压;心脏超声心动图提示：主动脉瓣重度狭窄、轻度关闭不全,主动脉瓣上隔膜型狭窄,升主动脉及弓部增宽,升主动脉直径53 mm,左心室内径44 mm,左心室肥厚,室间隔厚度19 mm,射血分数（EF）85%。术前CT示：主动脉根部狭窄,升主动脉扩张（图1）。     

腹腔镜与开腹胃间质瘤楔形切除的临床对比研究

目的探讨腹腔镜胃楔形切除治疗胃间质瘤的可行性。方法回顾性分析我院2002年9月~2009年4月腹腔镜胃间质瘤楔形切除术32例（腹腔镜组）和1999年10月~2009年1月开腹胃间质瘤楔形切除术20例（开腹组）的临床资料,比较2组围手术期的情况和预后。结果与开腹组相比,腹腔镜组手术时间短[120 min（23~210 min）vs 145 min（75~400 min）,Z=-2.960,P=0.003],术中出血量少[20 ml（5~100 ml）vs 50 ml（10~200 ml）,Z=-3.580,P=0.000],术后进食时间早[3 d（1~4 d）vs 3 d（3~21 d）,Z=-3.032,P=0.002],术后住院时间短[6 d（4~15 d）vs 8.5 d（6~26 d）,Z=-4.202,P=0.000]。腹腔镜组29例随访6~79个月（中位随访时间25个月）,开腹组16例随访9~120个月（中位随访时间58个月）,均无复发或转移。结论腹腔镜胃间质瘤楔形切除术安全、有效,具有可行性。