摘要
目的 探讨升主动脉-腹主动脉人工血管转流术治疗成人主动脉缩窄的手术效果、随访结果并总结其临床经验.方法 2008年5月至2009年7月,应用升主动脉-腹主动脉人工血管转流术治疗成人主动脉缩窄9例,其中男4例,女5例;平均年龄42.6岁.所有病人均经桡动脉、足背动脉穿刺测压,根据术前、术后,桡动脉、足背动脉平均压差变化评价手术效果.结果 术后均治愈出院.术前桡动脉足背动脉平均压差36～63 mm Hg（1 mm Hg=0.133 kPa）;术后24 h桡动脉足背动脉平均压差0～13 mm Hg,较术前明显缩小.随访1～13个月,术后上、下肢动脉平均压差均小于20 mm Hg,转流人工血管通畅,2例主动脉缩窄远端自体动脉部分闭塞.结论 升主动脉-腹主动脉人工血管转流术是治疗成人主动脉缩窄的有效手段.
Objective To explore the surgical effects and follow-up results in treating adult aortic coarctation patients using ascending aorta-abdominal aorta vascular prosthesis bypass and summarize the clinical experiences. Methods From May 2008 to July 2009, ascending aorta-abdominal aorta vascular prosthesis bypass surgery was performed in nine patients with adult aortic coarctation, among which, four were male, and five were female, with the average age of 42.6 years old. All patients had upper extremity hypertension, the systolic blood pressure difference between their upper extremities and lower extremities was 55 - 100 mm Hg, mean （70.2 ± 15. 6） mm Hg. Among which, seven cases showed descending aorta aneurysmal dilatation at coarctation segment distal end, with the wall thinning; two cases showed long segment stenosis; three cases showed aortic wall near coarctation segment was calcified. All cases belonged to complex aortic coarctation. All patients underwent radial artery and dorsalis pedis artery puncture manometry, the surgical effects were evaluated according to mean pressure difference changes between radial artery and dorsalis pedis artery before and after operations. Results All patients were cured and dispertension has been significantly improved, before operation, the mean pressure difference between radial artery and dorsalis pedis artery was 36 - 63 mm Hg, mean [（48.2 ± 5.6 ） mm Hg]; 24 hours after operation, the mean pressure difference between radial artery and dorsalis pedis artery was 0 - 13 mm Hg, mean [（6.2 ± 1.6） mm Hg], significantly reduced （ P 〈per extremity hypertension disappeared, no need for oral antihypertensive drugs, the mean pressure differences between upper extremities and lower extremities after operations were all less than 20 mm Hg, thoracoabodominal aorta main vessels multi-slice CT examination three months after operation showed that bypass vascular prosthesis was unobetructed, two cases showed that autologous artery at aortic coarctation distal end were partly occluded. Conclusion Ascending aorta-abdominal aorta vascular prosthesis bypass would be an effective means for the treatment of adult aortic coarctation patients.
出处
《中华胸心血管外科杂志》
CSCD
北大核心
2011年第1期11-13,共3页
Chinese Journal of Thoracic and Cardiovascular Surgery
