摘要
目的探索应用杂交技术治疗累及内脏动脉分支的复杂主动脉疾病的方法。方法应用杂交技术方法治疗4例累及内脏动脉分支的复杂主动脉疾病,除1例采用瘤腔内栓塞治疗结合主动脉裸支架覆盖以外,其余3例均用传统的旁路转流术来重建血供和维持内脏分支动脉的灌注,然后为主动脉病变提供腔内修复术的适当的治疗区域,避免主动脉完全阻断的后果,避免主动脉切开,减少手术中的缺血时间,极大地提高了手术的存活率,减少手术的死亡率和并发症发生率。结果本组4例中,均为男性,平均年龄62.5岁。最长的病例随访时间达5年,最短的随访16个月,除病例3以外,都获得较好的疗效,无特殊异常,均恢复日常生活或工作。病例3比较特殊,在恢复工作状态下,术后3个月来院常规复查,CTA检查提示瘤腔内有少量造影剂进入。说明瘤腔内部分血栓溶解再通,但病人无腹痛及发热等不适症状,考虑以随访及密切观察。至术后5个月时,患者出现腰背疼痛,伴高热,与初发症状时相仿。再次CTA检查提示瘤腔比原来体积扩大。经多方治疗无效,最后死于多器官功能衰竭。结论杂交技术方法能够有利的拓展对于累及内脏动脉分支的复杂主动脉疾病腔内修复术的治疗范围。
Objective A study on hybrid repair of aortic diseases involving the visceral and renal vessels.Methods We conducted a retrospective review of 4 cases who underwent renal/visceral bypasses or stent followed by aortic endovascular treatment.This therapeutic modality on hybrid repair of aortic diseases could obviously increase operative survival rate,decrease operative mortality rate and the incidence of postoperative complications.Results Mean age of the patients was 62.5 years.One patient suffered from acute aortic dissection with bilateral iliac aneurysm,2 did from abdominal aortic aneurysms and another did from infective abdominal aortic aneurysm.During follow-up,all the patients were survival and had good results except case 3 of infective abdominal aortic aneurysm had a endoleak and enlargement of aneurysm capacity after 3 months of operation.This patient died after 5 months of the treatment with embolism and bare stent in aortic therapeutics.Condusions Hybrid repair of high-risk patients with complex aortic aneurysms involving the renal and visceral arteries is a kind of feasible therapeutic measure and widen the indications for the patients with complex aortic diseases involving the visceral and renal vessels.
出处
《临床普外科电子杂志》
2013年第1期40-43,共4页
Journal of General Surgery for Clinicians(Electronic Version)
