“一站式”杂交手术在Stanford A型主动脉夹层患者治疗中的应用价值

目的研究"一站式"杂交手术在Stanford A型主动脉夹层患者治疗中的应用价值。方法选取2015年至2018年期间到北京大学深圳医院就诊的200例Stanford A型主动脉夹层患者进行研究,按数字表法随机分为研究组及常规组,每组100例。结果研究组患者addition EuroSCORE>7%以及Logistics EuroSCORE>6%的比例明显高于常规组,差异有统计学意义(66.0%vs. 36.0%,P<0.001;74.0%vs. 39.0%,P<0.001)。研究组患者比常规组患者具有更高的手术风险,差异有统计学意义(P<0.05)。研究组患者体外循环时间以及主动脉阻断时间比常规组均明显缩短,术后重症监护病房初次停留时间比常规组明显长,差异有统计学意义(P<0.001)。两组患者围术期死亡及术后30 d主要复合不良事件、脑卒中、截瘫、肾功能不全需血液透析辅助治疗的发生率比较,差异均无统计学意义(P>0.05)。结论 "一站式"杂交手术在Stanford A型主动脉夹层患者治疗能够缩减体外循环时间及主动脉阻断时间、降低患者手术创伤、提高手术安全。

Value of one-stop hybrid surgery in clinical Stanford type A aortic dissection

Objectives To study the value of one-stop hybrid surgery in the treatment of patients with Stanford type A aortic dissection.Methods A total of 200 patients with Stanford type A aortic dissection who visited Peking University Shenzhen Hospital from 2015 to 2018 were selected and randomly divided into study group and conventional group according to the digital table method,with 100 cases in each group.Results In study group,the percentage of patients with addition EuroSCORE>7%and Logistics EuroSCORE>6%were significantly higher than those in conventional group(66.0%vs.36.0%,P<0.001;74.0%vs.39.0%,P<0.001).Patients in study group had a higher risk of surgery than patients in conventional group(P<0.05).Extracorporeal circulation duration and aortic occlusion duration were significantly shorter,and the initial residence duration of intensive care unit(ICU)was significantly longer after operation in study group than in conventional group(P<0.001).There were no significant differences in the incidences of postoperative ealy major composite adverse events(EMCAEs),perioperative death,paraplegia and renal insufficiency requiring hemorrhage adjuvant therapy(P>0.05).Conclusions One-stop hybrid surgery in the treatment of patients with Stanford type A aortic dissection has obvious advantages in reducing extracorporeal circulation duration and aortic occlusion duration,reducing surgical trauma and improving surgical safety.