“雜交技术”治疗复杂主动脉病变的效果.docVIP

KKME---专业医学搜索引擎/ “杂交技术”治疗复杂主动脉病变的效果 　　作者：黄强,徐平,郝传吉,李筱琴,高洪波,李贞　　作者单位：青岛大学医学院附属医院心血管外科,山东 青岛 　　【摘要】 目的 探讨杂交技术mdash;mdash;主动脉人工血管替换并降主动脉覆膜支架置入术治疗复杂主动脉病变的效果。方法 2007年2～12月，采用术中支架系统(Micro-Port CRONUS)分别为7例主动脉夹层分离、主动脉瘤以及主动脉瘤并发主动脉夹层的病人实施了杂交技术治疗。结果 1例肾衰竭，自动出院。6例复查CTA显示升主动脉及主动脉弓部人工血管无扭曲、狭窄，血流通畅，带支架人工血管位置良好，降主动脉真腔较术前明显扩大，无内漏，假腔血栓形成无血流,痊愈出院。随访4～25个月，无复发。结论 应用杂交技术治疗复杂主动脉病变方法简单，疗效可靠，并发症少，具有良好的应用前景。 　　【关键词】 主动脉 　　HYBRID TECHNIQUE IN THE TREATMENT OF COMPLEX AORTIC DISEASE HUANG QIANG, XU PING, HAO CHUAN-JI, et al(Department of Cardiovascular Surgery, The Affiliated Hospital of Qingdao University Medical College, Qingdao 266003, China) [ABSTRACT]ObjectiveTo evaluate the experience of hybrid technique in the treatment of complex aortic diseases. MethodsFrom February to December 2007, seven patients with aortic dissection and aortic aneurysm or combined lesions were performed by hybrid technique ascending aortic prosthesis replacement plus descending aortic stent-grafting by using Micro-Port CRONUSTM.ResultsOne patient with renal failure discharged voluntarily, six patients had CTA examination two weeks after surgery. There were no torsion, stenosis and occlusion in the prosthesis. Stent-grafts were in good position. No leakage exsisted. True lumen of descending aorta was enlarged significantly and no blood current in false lumen was found. No recurrence occurred during 4-25 month follow-up.ConclusionHybrid technique seems to be an effective, safe, reliable and simple method in curing complex aortic disease.[KEY WORDS]Aneurysm, dissecting; Aortic aneurysm; Cardiac surgical procedures; Radiology, interventiona 　　主动脉瘤、主动脉夹层分离是主动脉外科极具挑战性的两大类疾病，其发病多急而凶险，而且有时两病并存，如不及时治疗多因动脉破裂或重要脏器缺血而导致死亡。根据病变部位不同，可分别采用手术切除瘤体或内膜破口，人工血管替换，弓部、降主动脉覆膜支架介入治疗等术式。2007年2～12月，我科采用术中支架系统(Micro-Port CRONUS)分别为7例主动脉夹层分离、主动脉瘤以及主动脉瘤并发主动脉夹层的病人实施了杂交技术mdash;mdash;主动脉人工血管替换+降主动脉覆膜支架置入术，治疗效果满意，现报告如下。 　　1 资料与方法 　　1.1 一般资料本组7例中，男2例，女5例;年龄35～52岁，平均47岁;病程5 h～7年;均有不同程度的胸闷、胸痛。经心电图、X线胸片、超声心动图、CTA等明确诊断。超声心动图显