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    李小军, 刘戈, 孟金金, 刁文杰, 施超. Stanford A型主动脉夹层术后早期死亡因素分析[J]. 蚌埠医科大学学报, 2021, 46(10): 1372-1375. DOI: 10.13898/j.cnki.issn.1000-2200.2021.10.012
    引用本文: 李小军, 刘戈, 孟金金, 刁文杰, 施超. Stanford A型主动脉夹层术后早期死亡因素分析[J]. 蚌埠医科大学学报, 2021, 46(10): 1372-1375. DOI: 10.13898/j.cnki.issn.1000-2200.2021.10.012
    shu
    LI Xiao-jun, LIU Ge, MENG Jin-jin, DIAO Wen-jie, SHI Chao. Analysis of early death factors after surgical treatment for Stanford type A aortic dissection[J]. Journal of Bengbu Medical University, 2021, 46(10): 1372-1375. DOI: 10.13898/j.cnki.issn.1000-2200.2021.10.012
    Citation: LI Xiao-jun, LIU Ge, MENG Jin-jin, DIAO Wen-jie, SHI Chao. Analysis of early death factors after surgical treatment for Stanford type A aortic dissection[J]. Journal of Bengbu Medical University, 2021, 46(10): 1372-1375. DOI: 10.13898/j.cnki.issn.1000-2200.2021.10.012
    shu

    Stanford A型主动脉夹层术后早期死亡因素分析

    Analysis of early death factors after surgical treatment for Stanford type A aortic dissection

      摘要
    • 摘要:
      目的 分析Stanford A主动脉夹层病人的治疗过程及结果，分析早期死亡因素。
      方法 回顾性分析51例Stantord A主动脉夹层外科治疗的临床资料、治疗方案及预后。依据病人是否死亡分为死亡组与非死亡组。
      结果 与非死亡组比较，死亡组病人主动脉根部明显受累，主动脉阻断时间较长，术中输血量更多，术后需要持续肾替代治疗（CRRT）与体外膜肺氧合（ECMO）辅助治疗更多，ICU停留时间和住院时间更长（P < 0.05~P < 0.01）。对死亡原因进行多元回归分析提示：主动脉根部受累、术后应用CRRT和ECMO与病人死亡成相关（OR值分别为9.714，8.831，10.997，P < 0.05）。
      结论 急诊手术是治疗Stanford A型主动脉夹层最有效方法。根部“三明治”技术解决根部出血和主动脉瓣关闭不全的有效方法。主动脉远端近段吻合止血方法是手术成败的关键。

       

      Abstract:
      Objective To analyze the treatment process and outcome of patients with Stanford A aortic dissection and summarize the experience of surgical treatment.
      Methods Retrospective analysis was performed on the surgical data, treatment plan and prognosis of 51 cases with Stanford type A aortic dissection.Patients were divided into death group and nondeath group according to whethe they died or not.
      Results Compared with the non-death group, patients in the death group were significantly involved in the aortic root, the aorta occlusion time was longer, the intraoperative blood transfusion volume was higher, more postoperative adjuvant therapy was required with CRRT and ECMO, and the stay time in ICU and hospitalization time were longer(P < 0.05 to P < 0.01).Multiple regression analysis of causes of death suggested that aortic root involvement, postoperative CRRT and ECMO were correlated with death(OR=9.714, 8.831 and 10.997, P < 0.05).
      Conclusions Emergency surgery is the most effective treatment for Stanford A aortic dissection.Root "sandwich" technique is an effective method for root bleeding and aortic valve insufficiency.The hemostasis of distal and proximal segments of aorta is the key to the success of the operation.

       

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