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目的:传统的主动脉夹层分型对主动脉弓段夹层和单纯腹主动脉夹层命名不明确，对手术方式的选择缺乏指导作用，因此阜外医院提出针对主动脉解剖受累情况划分。分析按阜外分型的不同类型主动脉夹层的临床特点和预后，明确对于手术方式选择的意义。方法:回顾性收集2010年1月1日至2015年12月31日1 570例主动脉夹层手术患者临床资料。比较阜外分型四种类型(A/B/C/D)以及弓部三种亚型(Cp/Ct/Cd)夹层患者术前、术中、术后资料以及手术方式的差异。结果:阜外A型78例(4.96%)，阜外B型421例(26.82%)，阜外C型1 063例(67.71%)，阜外D型8例(0.51%)。全组手术死亡85例(5.41%)。阜外A型主动脉窦直径最大，为(45.92±12.88)mm。阜外C型的术前肾功能不全比例最高(14.96%)。阜外D型患者年龄最大[(58.02±11.93)岁]。阜外C型的手术死亡比例最高，为7.71%。阜外C型患者中，Cp型、Ct型、Cd型比例为5.08%、78.27%、16.65%。Ct型与Cd型的手术死亡比例存在明显差异(9.38%对1.69%，n P<0.01)，Ct型与Cp型的手术死亡比例无明显差异(9.38%对1.85%，n P＝0.06)，Cp型与Cd型的手术死亡比例差异无统计学意义(1.85%对1.69%，n P＝0.94)。阜外A型单纯升主动脉置换术占64.10%，阜外B型单纯TEVAR占81.53%，阜外Cp型部分弓替换术占62.96%，阜外Ct型全主动脉弓替换术占98.56%，阜外Cd型去分支＋TEVAR或TEVAR占70.62%，阜外D型8例均行腹主动脉支架置入术。n 结论:阜外分型是对传统分型方法的总结和补充，系统、简洁地阐明夹层累及的范围，有利于主动脉夹层研究和治疗的统一。阜外分型中不同分型的夹层发病特点和预后不同。阜外分型对于主动脉手术方式的选择有较好的指导意义。“,”Objective:To explore the clinical application of Fuwai aortic dissection classification, including comparing the difference between the diverse types, and its meaning of aortic surgery selection.Methods:Retrospectively collected 1 570 aortic dissection surgery patients from January 1, 2010 to December 31, 2015 in Fuwai Hospital. Fuwai classification includes four types. Type A restricted to the ascending aorta. Type B refers to the descending aorta dissection below the left subclavian artery. Type C refers to dissection involve the aortic arch. Type D refers to the dissection restricted to the abdominal aorta below the diaphragm. The subtype of the type C include type Cp, type Ct and type Cd. Type Cp refers to the proximal aortic arch is involved (at least the left subclavian artery was not implicated). Type Ct refers to total aortic arch is involved. Type Cd refers to the distal aortic arch is involved (at least the innominate artery was not implicated). We compared the differences among the four types (A/B/C/D) and three subtypes (Cp/Ct/Cd) aortic dissection in preoperative, intro and postoperative characteristics.Results:There were 78 cases (4.96%) Fuwai type A, 421 cases (26.82%) Fuwai type B, 1063 cases (67.71%) Fuwai type C, and 8 cases (0.51%) Fuwai type D. The operative mortality was 5.41%. The average age of the patients in type D was the oldest, which was (58.02 ± 11.93) years. The preoperative renal insufficiency in type C was the highest, (14.96%). Type A had the largest aortic sinus diameter (45.92 ± 12.88 mm). Type C had the highest mortality(7.71%), followed by 0.71% of type B, and no surgical deaths occurred in type A and type D. Among type C patients, 54 patients were type Cp, 832 patients were type Ct, 177 patients were type Cd. Surgery mortality between type Ct and type Cd was significant difference (9.38% vs. 1.69%, n P<0.01). Type Ct had higher surgery mortality than type Cp, there was no difference (9.38% vs. 1.85%,n P=0.06). Type Cp and type Cd had no significant statistical difference in surgical mortality (1.85% vs. 1.69%, n P=0.94). Simply ascending aorta replacement accounted for 64.1% in type A , TEVAR accounted for 81.53% in type B , partial arch replacement accounted for 62.96% in type Cp, total aortic arch replacement accounted for 98.56% in type Ct, debranch+ TEVAR/TEVAR accounted for 70.62% in type Cd, EVAR accounted for 100% in type D.n Conclusion:The Fuwai classification is more comprehensive and practical for clinical application than the traditional classification. Different classification had different clinical characteristics and prognosis. The classification was helpful for surgical methods selection.