【摘要】 目的 :总结 1992年 6月至 2 0 0 2年 6月对 2 5例主动脉夹层动脉瘤病人的外科治疗经验。方法 :采用Cabrol手术 10例 ,Bentall手术 7例 ,升主动脉与腹主动脉搭桥转流手术 6例 ,升主动脉与双髂总动脉搭桥转流结合动脉内膜开窗手术 1例 ,升主动脉夹层缝闭加主动脉瓣成形术 1例。结果 :2 4例生存 ,1例Bentall手术左冠状动脉吻合口出血而死亡。结论 :主动脉夹层病人 ,手术中当冠状动脉开口直接缝合于人工血管有困难时 ,采用Cabrol手术 ,使吻合口无张力而且对合严密 ,避免了冠状动脉开口周围内膜撕脱和吻合口漏血。对于DeBakeyⅢ型的病人 ,采用升主动脉与腹主动脉或双髂总动脉搭桥转流术结合动脉内膜开窗术 ,治疗效果满意。对于手术中无法止血的主动脉漏血和左心室漏血 ,采用瘤袋或自体心包包裹漏血区 ,然后与右心房进行搭桥吻合 ,将漏血引入右心房而达到止血目的。更多还原

【Abstract】 Objective:To review the surgical results of aortic dissecting aneurysms.Method:From June 1992 to June 2002,25 patients with aortic dissecting aneurysms underwent surgical treatment.The procedures performed include 10 Cabrol operation,7 Bentall procedure,one of closure of dissection with aortic valvular plasty and 6 of deviation bypassing the dissected aorta.One patient was treated by ascending aorta\|both iliac artery bypass and fenestration.Result:24 patients survived with 1 postoperative death.The cause of death is leakage of the anastomosis of left coronary in Bentall procedure.Conclusion:The modification of Cabrol operation could improve surgical outcome of aortic dissection aneurysms.For Debakey Ⅲ aortic dissection aneurysm,a Dacron graft is implanted between ascending aorta and abdominal aorta or both iliac artery to bypass the dissected aorta treated combined with fenestration,the results are encouraging.A selfblood infusion system bypass is created in case of hemostatic failure between right atrium and aneurismal sac sewn around the Dacron graft. [更多还原