海南医学
海南醫學
해남의학
Hainan Medical Journal
2015年
21期
3215-3217
,共3页
陈浩%曹建军%刘伟%王宏宇%张光青%郑建设
陳浩%曹建軍%劉偉%王宏宇%張光青%鄭建設
진호%조건군%류위%왕굉우%장광청%정건설
血管旁路%腔内修复术%StanfordB型夹层
血管徬路%腔內脩複術%StanfordB型夾層
혈관방로%강내수복술%StanfordB형협층
Axillary-axillary bypass grafting%Endovascular repair%Stanford type B aortic dissection
目的 总结腋-腋动脉人工血管旁路联合腔内修复术治疗复杂型Stanford B型主动脉夹层的经验.方法 2011年2月至2014年12月,16例复杂型Stanford B型主动脉夹层患者于手术室全麻下行腋-腋动脉人工血管旁路术,转介入手术室经股动脉切口行主动脉腔内修复术治疗.结果 所有患者均手术成功,术毕造影均提示破口封闭良好,无内漏,旁路血管通畅.术后无椎基底供血不足及左上肢缺血症状;3例患者术后上肢麻木感,术后1~3个月均消失;左侧气胸1例.随访14例,失访2例,随访时间1~30个月,平均(18.0±3.6)个月,术后45 d猝死1例.术后3个月、1年复查主动脉CTA均示人工血管通畅、支架无移位和内漏,支架远端动脉瘤形成1例.结论 腋-腋动脉人工血管旁路联合腔内修复术治疗复杂型Standford B型主动脉夹层效果满意,手术操作简单易行,可降低手术风险,可减少脑部并发症,术后恢复时间短,具有实用价值.
目的 總結腋-腋動脈人工血管徬路聯閤腔內脩複術治療複雜型Stanford B型主動脈夾層的經驗.方法 2011年2月至2014年12月,16例複雜型Stanford B型主動脈夾層患者于手術室全痳下行腋-腋動脈人工血管徬路術,轉介入手術室經股動脈切口行主動脈腔內脩複術治療.結果 所有患者均手術成功,術畢造影均提示破口封閉良好,無內漏,徬路血管通暢.術後無椎基底供血不足及左上肢缺血癥狀;3例患者術後上肢痳木感,術後1~3箇月均消失;左側氣胸1例.隨訪14例,失訪2例,隨訪時間1~30箇月,平均(18.0±3.6)箇月,術後45 d猝死1例.術後3箇月、1年複查主動脈CTA均示人工血管通暢、支架無移位和內漏,支架遠耑動脈瘤形成1例.結論 腋-腋動脈人工血管徬路聯閤腔內脩複術治療複雜型Standford B型主動脈夾層效果滿意,手術操作簡單易行,可降低手術風險,可減少腦部併髮癥,術後恢複時間短,具有實用價值.
목적 총결액-액동맥인공혈관방로연합강내수복술치료복잡형Stanford B형주동맥협층적경험.방법 2011년2월지2014년12월,16례복잡형Stanford B형주동맥협층환자우수술실전마하행액-액동맥인공혈관방로술,전개입수술실경고동맥절구행주동맥강내수복술치료.결과 소유환자균수술성공,술필조영균제시파구봉폐량호,무내루,방로혈관통창.술후무추기저공혈불족급좌상지결혈증상;3례환자술후상지마목감,술후1~3개월균소실;좌측기흉1례.수방14례,실방2례,수방시간1~30개월,평균(18.0±3.6)개월,술후45 d졸사1례.술후3개월、1년복사주동맥CTA균시인공혈관통창、지가무이위화내루,지가원단동맥류형성1례.결론 액-액동맥인공혈관방로연합강내수복술치료복잡형Standford B형주동맥협층효과만의,수술조작간단역행,가강저수술풍험,가감소뇌부병발증,술후회복시간단,구유실용개치.
Objective To summarize the present experience on axillary-axillary bypass grafting and endovas-cular repair therapy for complicated Stanford type B aortic dissection. Methods From Feb. 2011 to Dec. 2014, 16 pa-tients with complicated Stanford type B aortic dissection were all treated with axillary-axillary bypass grafting under general anesthesia and then endovascular repair. Results All 16 patients were successfully operated. The crevasses were perfectly closed. No endoleak was found. And the patency rate after reconstruction was 100%. No ertebrobasilar insufficiency or left upper limb ischemia was found in patients. Three patients were found with upper limbs anaesthe-sia which recovered 1~3 months after the surgery, and one patient was found with left pneumothorax. Of 14 patients who were followed up for 1~30 months, with an average of (18.0 ± 3.6) months), one died 45 days after the surgery. The aortic CTA at 3 months and 12 months after surgery both showed good graft patency, no stent displacement and no endoleak. However, distal aneurysm was found in one patient. Conclusion Axillary-axillary bypass grafting com-bined with endovascular repair is a safe and effective treatment for complicated Stanford type B aortic dissection. It can help reduce the risk of surgery, a brain complications, and also shorten the recovery time.