CAJ | 학술논문

目的分析不同温度对Stanford A型主动脉夹层手术后效果的影响.方法回顾2007年4月至2012年3月65例接受主动脉根部成形加升主动脉置换加主动脉弓替换加支架象鼻术的Stanford A型主动脉夹层患者的临床资料.根据术中降温程度不同分为A、B两组,A组温度控制在20℃～24℃;B组温度控制在25℃～28℃.对比分析体外循环时间、术后引流量、呼吸机使用时间、术后脑部并发症的发生率等指标.结果两组术中体外循环时间、停循环时间、术后引流量、呼吸机使用时间以及术后短暂性神经系统功能障碍的发生率比较差异有统计学意义.术后永久性神经系统功能障碍的发生率、连续性肾脏替代治疗的使用以及术后死亡比例方面比较组间差异无统计学意义.结论低温停循环手术中,在保证熟练的手术操作的前提下,适当提高降温水平是安全的,也可以在一定程度上减小对患者身体的创伤、缩短手术时间和患者恢复时间,减少用血量,减少并发症.
목적 분석불동온도대Stanford A형주동맥협층수술후효과적영향.방법 회고2007년4월지2012년3월65례접수주동맥근부성형가승주동맥치환가주동맥궁체환가지가상비술적Stanford A형주동맥협층환자적림상자료.근거술중강온정도불동분위A、B량조,A조온도공제재20℃～24℃;B조온도공제재25℃～28℃.대비분석체외순배시간、술후인류량、호흡궤사용시간、술후뇌부병발증적발생솔등지표.결과 량조술중체외순배시간、정순배시간、술후인류량、호흡궤사용시간이급술후단잠성신경계통공능장애적발생솔비교차이유통계학의의.술후영구성신경계통공능장애적발생솔、련속성신장체대치료적사용이급술후사망비례방면비교조간차이무통계학의의.결론 저온정순배수술중,재보증숙련적수술조작적전제하,괄당제고강온수평시안전적,야가이재일정정도상감소대환자신체적창상、축단수술시간화환자회복시간,감소용혈량,감소병발증.
Objective To comparatively analyze effect of different cooling temperature on postoperative results of patients with Stanford type A aortic disaection underwent surgical treatment.Methods Clinical data of 65 patients with Stanford type A aortic dissection perforred aortic root shaping,ascending aorta and total aortic arch replacement combined with stented elephant trunk technique from April 2007 to March 2012 were retrospectively analyzed.According to the cooling temperature,the patients were divided into two groups:group A and group B.The cooling temperature was 20 ℃ to 24 ℃ in group A and 25 ℃ to 2.8 ℃ in group B.Extracorporeal circulation time,circulatory arrest periods,volume of postoperative drainage,ventilation time and cerebral complications incidence after operation were analyzed contrastively.Results There was significant difference between two groups about extracorporeal circulation time,circulatory arrest periods,volume of postoperative drainage,ventilationtime and transient neurological dysfunction(TND) incidence after operation.There was no significant difference between two groups in postoperative pemunent neurological dysfunction (PND),use of continuous renal replacement therapy (CRRT) and mortality.Conclusion It is safe to appropriately increase the standard of cooling temperature through operating skillfully under the circumstance of deep hypothermic circulatory arrest.It,to some extent,shortens operating time and decreases injuries on patients,time of recovery,volume of blood transfusion and complications.