CAJ | 학술논문

目的：总结48例急性 A 型主动脉夹层外科治疗的临床经验。方法选取我院2009年6月至2014年6月48例急性 A 型主动脉夹层患者资料进行回顾性分析，这些患者行升主动脉及主动脉弓部置换加术中支架植入术，包括 Bentall 术28例，近端单纯升主动脉置换20例。结果住院死亡者2例（4.16％），其中1例术中心功能较差，无法撤离体外循环而死亡；另1例术后长期昏迷，其家属放弃治疗而自动出院。偏瘫者1例、一过性肾功能不全者3例、声音嘶哑者5例、胸部切口感染者2例、处理后恢复良好。46例出院前复查主动脉 CTA 见升主动脉及主动脉弓部人工血管无扭曲、血流通.，无假性动脉瘤形成。随访43例患者术后1、6月、1年复查见降主动脉假腔闭合率约80％，降主动脉及腹主动脉扩张者3例，腹主动脉假性动脉瘤者1例，无死亡及再次手术者。结论手术治疗急性 A 型主动脉夹层更为有效、安全。
목적：총결48례급성 A 형주동맥협층외과치료적림상경험。방법선취아원2009년6월지2014년6월48례급성 A 형주동맥협층환자자료진행회고성분석，저사환자행승주동맥급주동맥궁부치환가술중지가식입술，포괄 Bentall 술28례，근단단순승주동맥치환20례。결과주원사망자2례（4.16％），기중1례술중심공능교차，무법철리체외순배이사망；령1례술후장기혼미，기가속방기치료이자동출원。편탄자1례、일과성신공능불전자3례、성음시아자5례、흉부절구감염자2례、처리후회복량호。46례출원전복사주동맥 CTA 견승주동맥급주동맥궁부인공혈관무뉴곡、혈류통.，무가성동맥류형성。수방43례환자술후1、6월、1년복사견강주동맥가강폐합솔약80％，강주동맥급복주동맥확장자3례，복주동맥가성동맥류자1례，무사망급재차수술자。결론수술치료급성 A 형주동맥협층경위유효、안전。
Objective To review the experience of surgical treatment of 48 patients with acute aortic dissection type A .Meth‐ods We retrospectively analyzed the clinical data of forty‐eight patients with acute aortic dissection type A that underwent as‐cending aorta and total aortic arch replacement combined with transaortic stented graft implantation into the descending aorta , including Bentall procedure in 28 cases ,graft replacement of ascending aorta in 20 cases .Results The in‐hospital mortality was 4 .16% ,and 43 patients(89.58% ) were followed up for 12 months ,during which no case of death and reoperation was found . Conclusion Surgical management for acute aortic dissection type A has an excellent effect .