外科治疗主动脉夹层265例临床分析

目的：总结分析外科治疗主动脉夹层的临床经验。方法265例主动脉夹层患者，根据其病情特点采取针对性的手术方式。结果170例Stanford A型死亡19例，95例Stanford B型死亡3例，其余均治愈出院，术后随访6~12个月，经多排螺旋CT检查显示，主动脉远端真腔扩大，假腔显著缩小，人工血管血流通畅。心功能逐渐恢复至Ⅱ级~Ⅰ级。结论手术是挽救ADA患者生命的重要治疗方法，宜以操作简便、疗效肯定为原则，具体应根据ADA破口特点、主动脉及其瓣膜情况来选择。本组采用了多种术式，尤其是EVGE术，具有微创、安全、恢复快、近期疗效确切、病死率低等特点。

Clinical analysis of surgical management for aortic dissection aneurysm in 265 cases

Objective To summarize the surgical experience of surgical management for aortic dissection aneurysm. Methods A total of 265 patients with aortic dissection aneurysm were treated with surgical management and the surgi-cal approach were chosen according to the condition. Results There were 170 cases Stanford A ADAs and 95 Stanford B patients. After following-up for 6 to 12 months, of which 19 and 3 cases died, respectively, and in the survivals, whose CTA displayed artificial vessel were unobstructed,the endovascular stents were fixed well.The heart function re-covered to Ⅱ-Ⅰ stage. Conclusion Surgery is an important method to save the patients with aortic dissection a-neurysm,the choice of surgical procedures depend on the location of intimal tear of aortic dissection. Proper surgical indication,technique and brain protections are the key factors of aortic dissection surgery. EVGE is a minimally inva-sive,effective,safe surgery in treating Stanford type B aortic dissection aneurysm.