心血管外科杂志（电子版）
心血管外科雜誌（電子版）
심혈관외과잡지（전자판）
Journal of Cardiovascular Surgery(Electronic Edition)
2014年
2期
70-73
,共4页
王亮%常谦%田川%魏以桢%韩超%裴华伟
王亮%常謙%田川%魏以楨%韓超%裴華偉
왕량%상겸%전천%위이정%한초%배화위
主动脉缩窄%一站式%杂交%支架
主動脈縮窄%一站式%雜交%支架
주동맥축착%일참식%잡교%지가
Aortic coarctation%One-stage%Hybrid%Stent
目的探讨一站式杂交技术（ one-stage hybrid technique ）治疗合并其他心血管疾病的复杂型主动脉缩窄的临床应用价值。方法回顾性分析2011年1月至2013年9月阜外医院血管外科中心收治的复杂型主动脉缩窄15例，均为男性，平均（26.93±9.84）岁（13～46岁）。全部患者均在杂交手术室一期完成手术，先经股动脉置入球囊扩张支架，然后正中开胸，常规体外循环下行Bentall等手术。结果15例手术均成功完成，术后上下肢压差（8.67±4.81） mm Hg。同期外科手术包括Bentall 手术7例，主动脉瓣置换术4例，单纯二尖瓣置换术1例，二尖瓣成形术2例，室间隔缺损修补1例。体外循环时间（67.38±19.67） min，支架长度（37.29±3.34）mm，ICU时间（42.35±24.89）h。随访3～24个月，院内及随访无死亡病例，无支架移位等并发症。结论一站式杂交技术治疗复杂型主动脉缩窄安全、有效，住院效果满意，早中期随访结果良好。由于样本量较少，随访时间较短，尚需进一步随访评估远期疗效。
目的探討一站式雜交技術（ one-stage hybrid technique ）治療閤併其他心血管疾病的複雜型主動脈縮窄的臨床應用價值。方法迴顧性分析2011年1月至2013年9月阜外醫院血管外科中心收治的複雜型主動脈縮窄15例，均為男性，平均（26.93±9.84）歲（13～46歲）。全部患者均在雜交手術室一期完成手術，先經股動脈置入毬囊擴張支架，然後正中開胸，常規體外循環下行Bentall等手術。結果15例手術均成功完成，術後上下肢壓差（8.67±4.81） mm Hg。同期外科手術包括Bentall 手術7例，主動脈瓣置換術4例，單純二尖瓣置換術1例，二尖瓣成形術2例，室間隔缺損脩補1例。體外循環時間（67.38±19.67） min，支架長度（37.29±3.34）mm，ICU時間（42.35±24.89）h。隨訪3～24箇月，院內及隨訪無死亡病例，無支架移位等併髮癥。結論一站式雜交技術治療複雜型主動脈縮窄安全、有效，住院效果滿意，早中期隨訪結果良好。由于樣本量較少，隨訪時間較短，尚需進一步隨訪評估遠期療效。
목적탐토일참식잡교기술（ one-stage hybrid technique ）치료합병기타심혈관질병적복잡형주동맥축착적림상응용개치。방법회고성분석2011년1월지2013년9월부외의원혈관외과중심수치적복잡형주동맥축착15례，균위남성，평균（26.93±9.84）세（13～46세）。전부환자균재잡교수술실일기완성수술，선경고동맥치입구낭확장지가，연후정중개흉，상규체외순배하행Bentall등수술。결과15례수술균성공완성，술후상하지압차（8.67±4.81） mm Hg。동기외과수술포괄Bentall 수술7례，주동맥판치환술4례，단순이첨판치환술1례，이첨판성형술2례，실간격결손수보1례。체외순배시간（67.38±19.67） min，지가장도（37.29±3.34）mm，ICU시간（42.35±24.89）h。수방3～24개월，원내급수방무사망병례，무지가이위등병발증。결론일참식잡교기술치료복잡형주동맥축착안전、유효，주원효과만의，조중기수방결과량호。유우양본량교소，수방시간교단，상수진일보수방평고원기료효。
Objective To evaluate the effective of one-stage hybrid technique in the management of complicated aortic coarctation in adolescents and adults .Methods To analysis 15 adolescents and adults retrospectively with complicated aortic coarctation from January 2011 to September 2013 in the aortic surgery center of Fuwai hospital .They were all male and the average age was 26.93 ±9.84 ( 13-46 ) years old .They were all operated in one-stage in the hybrid operation room , and balloon-expandable stents were transplanted firstly .Then surgeries were operated sternotomy through cardiopulmonary bypass ( CPB ) .Results All the procedures were completed successfully ,as 7 Bentall procedures ( include 1 semi-arch replacement and 1 mitral valve replacement ) , 4 aortic valve replacements , 1 mitral valve replacement , 2 mitral valve repairs , and 1 VSD repair were operated simultaneously .The average blood pressure drop of upper and lower limbs was ( 8.67 ±4.81 ) mm Hg post-operation.The CPB duration was (67.38 ±19.67 ) min and the length of ICU stay was (42.35 ±24.89 ) h.The average length of stents was (37.29 ±3.34 ) mm.During in-hospital and follow up (3-24 months),there were no complications .Conclusions It is secure and effective of one-stage hybrid technique in the management of complicated aortic coarctation in the adolescents and adults for the satisfactory in-hospital and follow up results ,but further follow up is needed for the late results .
