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目的:探讨右腋动脉或右锁骨下动脉选择性顺行脑灌注在主动脉夹层手术中应用价值。方法:回顾性分析采用深低温停循环+右腋动脉或右锁骨下动脉选择性顺行脑灌注手术治疗Debakey Ⅰ型主动脉夹层12例患者的临床资料。结果:12例均行升主动脉+全弓置换+降主动脉术中支架置入术。全程转流154~298 min,主动脉阻断时间78~142 min,深低温停循环时间15~40 min,选择性脑灌注时间15~40 min。本组手术死亡1例,术后短暂脑损害1例,无永久性脑损害发生。结论:右腋动脉或右锁骨下动脉选择性顺行脑灌注在Debakey Ⅰ型主动脉夹层手术中可提供有效的脑保护,其操作简便、安全。
Objective: To investigate the value of right anterior axillary artery or right subclavian artery selective cerebral perfusion in aortic dissection. Methods: The clinical data of 12 patients with Debakey type Ⅰ aortic dissection undergoing selective cisternal perfusion of deep hypothermic circulatory arrest + right axillary artery or right subclavian artery were retrospectively analyzed. Results: All 12 cases underwent ascending aorta + total arch replacement + descending aorta stenting. Full flow of 154 ~ 298 min, aortic blocking time 78 ~ 142 min, deep hypothermic circulatory arrest 15 ~ 40 min, selective cerebral perfusion time 15 ~ 40 min. The group of surgical death in 1 case, postoperative transient brain damage in 1 case, no permanent brain damage occurred. CONCLUSION: Selective cerebral perfusion of right axillary or right subclavian artery provides effective brain protection in Debakey type I aortic dissection, which is easy and safe to operate.