改良带瓣管道减少急性Stanford A型主动脉夹层 Bentall手术出血的临床分析

目的探讨改良带瓣管道对急性Stanford A型主动脉夹层患者行Bentall手术出血量的影响。方法回顾性分析60例行Bentall手术的急性Stanford A型主动脉夹层病例,根据手术方法的不同分为A组和B组,每组各30例;A组采用传统带瓣管道,B组采用改良带瓣管道。统计分析2组病例术后的出血量、输血量、近端吻合口吻合时间以及止血时间(从恢复体外循环到关胸的时间)。结果 B组病例的近端吻合口吻合时间(22.7±2.8)min较A组(18.3±5.0min)稍长(P>0.05),但B组病例的术后引流量(684.0±322.7)mL、输悬浮红细胞(9.7±4.1)U及止血时间(15.3±2.5)min均明显少于A组(P<0.05)。结论在急性Stanford A型主动脉夹层Bentall手术中,采用改良带瓣管道能明显减少术后的出血量和输血量。

The Clinical Study of Modified Composite Valve Dacron Graft on Reducing Operation Hemorrhage in Bentall Procedure of Acute Stanford Type A Aortic Dissection

Objective To investigate the influence of operation hemorrhage in acute Stanford typed A aortic dissection patients who went through Bentall procedure.Methods Sixty acute Stanford type A aortic dissection patients who went through Bentall procedure were analyzed retrospectively,and they were divided into group A and group B based on different surgical methods,with thirty patients for each group.Group A used the traditional composite valve dacron graft,and group B used the modified composite valve dacron graft.The amount of post-operative bleeding,the amount of blood transfusion,the anastomosis time of the proximate anastomotic stoma,and the hemostasis time(from rebound CPB to close chest) were analyzed.Results In group B,the anastomosis time of the proximate anastomotic stoma(22.7±2.8 min) was a little longer than that in group A(18.3±5.0 min),but the amount of post-operative bleeding(684.0±322.7 mL),the amount of blood transfusion(9.7±4.1 U)and the hemostasis time(15.3±2.5 min)were all less than those in group A(1 019.3±308.6 mL,15.1±3.1 U and 47.5±11.5 min respectively),the differences were significant(P<0.05).Conclusions In Bentall procedure of the acute Stanford typed A aortic dissection,the use of the modified composite valve dacron graft can obviously reduce the amount of post-operative bleeding and the amount of blood transfusion.