孙手术中右腋窝和股动脉插管的回顾性研究

Kaiyue Jin, H. Qiao, Xiaonan Li, Yingen Feng, Lin Li, Yong-min Liu, Junming Zhu, Li-Zhong Sun
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摘要

目的总结孙手术中右腋窝及股动脉插管主动脉夹层的解剖特点。探讨右腋窝和股动脉插管是否能降低器官灌注不良的发生率,改善患者预后。方法选取2015年1月至2017年12月首都医科大学附属北京安贞医院、北京大血管研究与治疗中心收治的181例主动脉夹层患者,其中右腋窝及股动脉插管组122例,对照组59例。回顾性分析两组资料,比较两组术中、术后单变量资料。结果术后组共死亡17例,其中联合灌注组死亡9例(7.38%),对照组死亡8例(13.56%),P=0.181。两组并发症中,联合灌注组18例(14.75%)出现肾功能不全,对照组17例(28.81%)出现肾功能不全,P= 0.025。联合灌注组发生短暂性脊髓损伤0例,对照组3例(5.08%),P=0.033。结论右腋窝和股动脉插管可减少术后脏器功能障碍并发症的发生,改善患者预后。关键词:Stanford A主动脉夹层;右腋窝和股动脉插管;器官malperfusion
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Retrospective study of right axillary and femoral artery cannulation in Sun’s operation
Objective Summarize the anatomical features of the aortic dissection of right axillary and femoral artery cannulation in Sun's surgery. Exploring whether right axillary and femoral artery cannulation can reduce the incidence of organ malperfusion and improve patient prognosis. Methods From January 2015 to December 2017, 181 cases with aortic dissection were treated in Beijing Anzhen Hospital affiliated to Capital Medical University, Beijing Great Blood Vessel Research and Treatment Center, 122 patients were enrolled in the right axillary and femoral artery cannulation group, and 59 patients in control group were enrolled. Retrospective analysis the data of two groups, intraoperative, and postoperative univariate were compared between the two groups. Results A total of 17 patients died in the postoperative group, with 9 (7.38%) in the combined perfusion group and 8 (13.56%) in the control group, P=0.181. Among the complications of the two groups, 18 patients(14.75%) in combined perfusion group had renal insufficiency and 17 patients (28.81%) in the control group, P= 0.025. 0 case had stransient spinal cord injury in combined perfusion group , 3 cases(5.08%) in control group , P=0.033. Conclusion Right axillary and femoral artery cannulation can reduce the incidence of complications of postoperative organ dysfunction and improve patient prognosis. Key words: Stanford A aortic dissection; Right axillary and femoral artery cannulation; Organ malperfusion
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