杂交手术一站式治疗Stanford A型主动脉夹层临床分析

目的探讨杂交手术一站式治疗Stanford A型主动脉夹层(AD)患者的方法及临床效果。方法选取2018年2月至2019年12月本院收治的5例Stanford A型AD患者,患者均进行杂交手术一站式治疗,术后2个月均复查全主动脉CT血管造影(CTA),评价人工血管及支架血流通畅情况。结果 5例患者均成功完成杂交手术一站式治疗,术中及术后无死亡病例。术中血管造影显示,AD真腔恢复正常血流,支架植入位置准确,且无明显移位,未发现血流内漏。围手术期未发生严重并发症。术后随访6个月,5例患者均生存良好,并均恢复正常生活。术后2个月复查CTA显示,人工血管及支架内血流通畅度良好,AD破口封闭良好,支架位置无偏移及无血流内漏。结论杂交手术一站式治疗Stanford A型AD具有创伤小、手术时间短、术后恢复快等优点,且可避免深低温停循环的影响,术后早期效果满意。

The clinical analysis of one-stop hybrid surgery for Stanford type A aortic dissection(AD)

Objective To explore the method and clinical effect of one-stop hybrid surgery for Stanford type A aortic dissection(AD). Methods 5 patients with Stanford type A AD who were admitted to our hospital from February 2018 to December 2019 were selected. All patients underwent one-stop hybrid surgery treatment, and the CT angiography of the whole aorta(CTA) was reviewed at 2 months after surgery to evaluate the smooth blood flow of the artificial blood vessel and stent. Results One-stop hybrid surgery treatment was successfully completed in 5 patients. There were no deaths during or after the operation. Intraoperative angiography showed normal blood flow in the true cavity of AD. The position of the stent implantation was accurate, and there was no obvious displacement, and no leakage of blood flow was found. No serious complications occurred during the perioperative period. After 6 months of follow-up, all 5 patients survived well and all returned to normal life. A CTA review 2 months after surgery showed that the blood flow in the artificial blood vessel and the stent was good, the AD rupture was well sealed, and there was no deviation of the stent position and no blood leakage. Conclusion The one-stop hybrid surgery treatment for Stanford A type AD patients has the advantages of less trauma, shorter operation time, and faster postoperative recovery, and can avoid the effects of deep hypothermia circulatory arrest, and the early postoperative results are satisfactory.