CAJ | 학술논문

目的总结近年来应用传统开放手术和腔内修复杂交技术治疗胸腹主动脉病变的经验及效果.方法 2008年6月至2011年9月收治胸腹主动脉病变患者11例,其中男性9例,女性2例,平均年龄52岁.胸腹主动脉瘤5例,胸腹主动脉夹层4例,大动脉炎并发动脉瘤2例.根据病变不同部位,首先行不同的内脏动脉或肾动脉旁路手术,再行主动脉腔内覆膜支架修复.结果手术均成功完成.同期手术平均手术时间8.5h,分期手术平均一期手术时间8.1h,平均腔内手术时间2.0h.平均随访时间13.5个月,1例患者术后3个月死于心肌梗死,无动脉瘤相关死亡,无肾功能不全和截瘫,2例发生内漏.结论杂交手术治疗胸腹主动脉病变可以减少手术创伤,是一种安全、可行的方法,早期及中期疗效满意,长期效果有待进一步随访.
목적 총결근년래응용전통개방수술화강내수복잡교기술치료흉복주동맥병변적경험급효과.방법 2008년6월지2011년9월수치흉복주동맥병변환자11례,기중남성9례,녀성2례,평균년령52세.흉복주동맥류5례,흉복주동맥협층4례,대동맥염병발동맥류2례.근거병변불동부위,수선행불동적내장동맥혹신동맥방로수술,재행주동맥강내복막지가수복.결과 수술균성공완성.동기수술평균수술시간8.5h,분기수술평균일기수술시간8.1h,평균강내수술시간2.0h.평균수방시간13.5개월,1례환자술후3개월사우심기경사,무동맥류상관사망,무신공능불전화절탄,2례발생내루.결론 잡교수술치료흉복주동맥병변가이감소수술창상,시일충안전、가행적방법,조기급중기료효만의,장기효과유대진일보수방.
Objectives To review the experience with the hybrid operations for patients with thoracoabdominal aortic diseases,as well as to evaluate and discuss the outcomes.Methods Between June 2008 and September 2011,11 patients (9 male and 2 female,mean age 52 years) were treated by hybrid operation.Hybrid operation includes debranching of the visceral arteries,followed by endovascular repair of the diseases (include aneurysmal disease,aortic dissection,or Takayasu's arteritis).Results All the operations were successful.The mean operating time was 8.5 hours for patients done in one stage and 8.1 hours for the first stage of patient related in two stages.The endovascular stage took on average 2.0hours.Overall mortality rate was 1/11 and morbidity was 4/11.No aneurysm-related death occurred.Two patients developed endoleak.Permanent paraplegia and renal failure rate was 0.Mean follow-up was 13.5months.Conclusion Hybrid operation is a mini invasive and safe method for thoracoabdominal aortic diseases with acceptable morbidity and mortality.