顺行和逆行脑保护与急性主动脉夹层术后并发症的关系
王正飞,王克学,杨再珍,王红宇,刘春明
摘要(Abstract):
目的回顾性分析顺行和逆行脑保护方法及其与术后并发症的关系。方法对48例A型主动脉夹层病人在深低温体外循环(DHCA)下施行主动脉置换手术。15例行全动脉弓置换,33例行部分主动脉弓部置换。依据脑保护方法不同分为:顺行脑灌注(ACP)组23例(A组);逆行脑灌注(RCP)组25例(B组)。结果 A、B 2组在心肺转流时间、脑缺血时间、脑灌注时间、神经系统永久损伤和病死率方面比较,差异无统计学意义(P>0.05)。暂时性神经损伤的发生率、平均拔管时间、入住ICU的平均时间、平均住院时间比较差异有统计学意义(P<0.05)。结论顺行灌注可以显著性减少暂时性神经系统并发症,更早的拔管,ICU和住院时间更短,费用更低。
关键词(KeyWords): 顺行脑灌注;逆行脑灌注;主动脉夹层
基金项目(Foundation):
作者(Author): 王正飞,王克学,杨再珍,王红宇,刘春明
参考文献(References):
- [1]Feldman M,Shah M,Elefteriades JA.Medical management ofacute type A aortic dissection[J].Ann Thorac CardiovascSurg,2009,15(5):286-293.
- [2]Elefteriades JA,Feldman M.Acute type A aortic dissection:surgical intervention for all:CON[J].Cardiol Clin,2010,28(2):325-331.
- [3]Tran TP,Khoynezhad A.Current management of type B aor-tic dissection[J].Vasc Health Risk Manag,2009,5(1):53-63.
- [4]Karthikesalingam A,Holt PJ,Hinchliffe RJ,et al.The diag-nosis and management of aortic dissection[J].Vasc Endovascu-lar Surg,2010,44(3):165-169.
- [5]Erbel R,alfonso F,Boileau C,et al.Diagnosis and manage-ment of aortic dissection[J].Euro Heart J,2001,22(18):1642-1 681.
- [6]王平凡.主动脉夹层瘤的诊断与治疗[J].医学信息手术学分册,2006,19(5):3-5.
- [7]Stamou SC,Hagberg RC,Khabbaz KR,et al.Is advanced agea contraindication for emergent repair of acute type A aorticdissection[J].Interact Cardiovasc Thorac Surg,2010,10(4):539-544.
- [8]Geirsson A.Extended arch resection in acute type A aortic dis-section:CON[J].Cardiol Clin,2010,28(2):343-347.