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目的探讨主动脉夹层的适宜手术时机,不同分型的手术对策。方法回顾性总结所有夹层(包含马凡综合征2例)病例的治疗时间安排和手术方式。结果手术13例无早期死亡,DebakeyⅠ型4例,行全弓及升主动脉置换;马凡综合征2例采用BENTALL术式;DebakeyⅢ型7例,早期2例采用常温下病变主动脉切除人造血管置换,目前采用直视下植入CROUNS术中支架;还有1例采用了介入经皮支撑型人工血管植入术。DebakeyⅠ型1例未手术死亡。(手术组与非手术组t检验P<0.05)。结论主动脉夹层外科干预有效,不同分型的夹层(瘤)手术方法和时机迥异。
Objective To investigate the appropriate timing of surgery and different surgical methods for aortic dissection. Methods Retrospectively summarizes the treatment schedule and operation mode of all cases (including 2 cases of Marfan syndrome). Results There were no early deaths in 13 cases, Debakey type I in 4 cases and total aortic arch replacement in 2 cases. Marfan syndrome was treated by BENTALL technique and Debakey Ⅲ type in 7 cases. In the early 2 cases, Replacement, currently under direct vision implantation CROUNS intraoperative stent; there is a case of interventional percutaneous stent graft. One patient with Debakey type I died without surgery. (T test between operation group and non-operation group P <0.05). Conclusions Surgical intervention of aortic dissection is effective. Different surgical methods and timing of dissection are different.