个体化腔内单分支覆膜支架重建主动脉弓部术治疗Stanford A型主动脉夹层26例

摘要

Objective To summarize the individualized cavity Single branch stent grafting through rebuilding the aortic arch surgery in 26 cases of the application of the Stanford type A aortic dissection. Methods From 2010 January to 2014 October, 26 patients received Stanford type A aortic dissection surgery, 26 patients received individualized cavity single branch stent grafting to rebuild the aortic arch surgery , together with improved myocardial protection fluid. Results In the present study, 26 cases with aortic dissection that were treated with single branch stent grafting for the reconstruction of aortic arch under DHCA and selective cerebral perfusion. Twenty-six patients received individualized cavity single branch stent grafting reconstruction of aortic arch surgery alone, and were stopped by using deep cryogenic loop (DHCA) plus selective cerebral perfusion surgical treatment. One patient suffered from permanent nerve dysfunction iand give up treatment. Conclusion The sexua branch stent grafting in reconstruction of aortic arch operation could simplify the operation procedures , shorten the operation time, and reduce the amount of blood transfusion and postoperative drainage.%目的：总结个体化腔内单分支覆膜支架重建主动脉弓部手术治疗在26例Stanford A 型主动脉夹层中的应用。方法：自2010年1月至2014年10月，对26例Stanford A 型主动脉夹层患者行手术治疗，26例患者以个体化腔内单分支覆膜支架重建主动脉弓部手术治疗，采用改良心肌保护液。结果：26例患者以个体化腔内单分支覆膜支架重建主动脉弓部手术治疗，深低温停循环（DHCA）加选择性脑灌注手术治疗主动脉夹层26例，术后1例患者出现永久性神经功能障碍患者放弃治疗，5例出现一过性神经功能障碍，4例出现一过性肾功能障碍，无手术中死亡，无术后严重低心排和多脏器功能衰竭，均治愈出院。26例患者中，25例痊愈出院，1例自动出院。结论：新型个体化腔内单分支覆膜支架重建主动脉弓部手术简化了手术步骤，可以明显缩短手术时间，手术中采用合适的脑保护方法，术后及时处理并发症，可取得良好的手术效果，该技术安全有效，值得在临床推广应用。