手术和药物联合治疗大动脉炎

摘要

目的 总结围手术期术前药物治疗方案结合外科手术治疗大动脉炎的效果.方法 回顾2010年1月至2015年12月,于安贞医院接受心血管手术的46例大动脉炎患者资料,收集其临床特征、术前药物治疗方案、手术治疗方案,病理检查结果,分析患者手术情况、药物治疗影响和围手术期情况.结果 46例患者的围手术期手术死亡1例,占2.2％.术后并发症11例,占23.9％,其中7例术前病情处于活动期,10例术前未使用激素类药物.围手术期34例患者症状缓解,术前病情均未处于活动期,11例术前未使用激素类药物.结论 手术治疗合并心血管疾病的大动脉炎患者能够有效改善症状.大动脉炎处于活动期将会影响手术效果.术前合理服用激素类药物的联合治疗,能将有效控制病情,提高症状缓解比例,有效减低围手术期并发症发生比例.%Objective To summarize surgical treatment of Takayasu arteritis,and analysis the drug treatment effect during the perioperative period.Methods Retrospective analysis 46 patients with Takayasu's arteritis disease and received cardiovascular surgery between January 2010 to December 2015,in Anzhen Hospital.By collecting their clinical characteristics,preoperative drug therapy,surgical treatment,pathological examination results to analyze operation conditions,effect of drugs and preoperative conditions.Results The perioperative mortality rate was 2.2％ and the complication rate was 23.9％ in 46 patients.There were 34 patients with symptomatic relief in the perioperative period,11 patients didn't take hormone drugs before operation.There were 11 cases of complications during the perioperative period,of which 7 patients were in active stage and 10 patients had not been used before operation.Conclusion The surgical treatment of patients with Takayasu's arteritis disease can effectively improve symptoms.The patients in Takayasu's arteritis active stage will affect the outcome of the surgery.Rational use of hormone drugs before surgery,can effectively control the patient's condition,improve the rate of remission of symptoms,and effectively reduce the incidence of perioperative complications.