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山东大学学报（医学版） ›› 2016, Vol. 54 ›› Issue (12): 27-31.doi: 10.6040/j.issn.1671-7554.0.2016.871

• 临床医学 • 上一篇    下一篇

主动脉瓣置换术后抗凝对DeBakeyⅠ型主动脉夹层残余假腔重塑效果的临床影响

王龙1,赵鑫1,李媛媛2,王锡明2,李德才3,宋光民1   

  1. 1. 山东大学齐鲁医院心脏外科, 山东 济南 250012;2.山东省医学影像研究所, 山东 济南 250021;3. 山东大学附属省立医院心脏外科, 山东 济南 250021
  • 收稿日期:2016-07-20 出版日期:2016-12-10 发布日期:2016-12-10
  • 通讯作者: 宋光民. E-mail:songgm@sdu.edu.cn赵鑫. E-mail:zhaoxin3617@126.com E-mail:songgm@sdu.edu.cn
  • 基金资助:
    国家自然科学基金青年项目(81500367)

Effect of anticoagulation on the remodeling of residual false lumen after aortic valve replacement of DeBakey type I aortic dissection

WANG Long1, ZHAO Xin1, LI Yuanyuan2, WANG Ximing2, LI Decai3, SONG Guangmin1   

  1. 1. Department of Cardiovascualar Surgery, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China;
    2. Shandong Medical Imaging Research Institute, Jinan 250021, Shandong, China;
    3. Department of Cardiovascualar Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong, China
  • Received:2016-07-20 Online:2016-12-10 Published:2016-12-10

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摘要： 目的 探讨主动脉瓣置换术后抗凝对DeBakeyⅠ型主动脉夹层残余假腔重塑的影响。 方法 回顾性收集2014年10月至2015年6月山东大学齐鲁医院和山东大学附属省立医院心脏外科收治的Ⅰ型主动脉夹层患者31例,其中行孙氏手术20例(未换瓣组),行孙氏手术+主动脉瓣置换术11例(换瓣组);术后3~6个月,复查主动脉CT血管成像(CTA),分别测量支架起始、支架中段、支架末端、腹腔干水平、肠系膜上动脉水平、双肾动脉水平术前术后真假腔直径以及真腔与管腔的比值,并观察假腔血栓化形成情况。 结果 术前换瓣组与未换瓣组在术前支架起始、支架中段、支架末端、腹腔干、肠系膜上动脉、双肾动脉断层平面,真腔直径与主动脉直径的比值无明显差异(P=0.30、0.94、0.96、0.54、0.83、0.49)。术后3~6个月换瓣组与未换瓣组支架起始、中段、末端及腹腔干、肠系膜上动脉和肾动脉6个主动脉CT断层测量平面中真腔或支架内径与主动脉直径的比值无明显差异(P=0.28、0.16、0.28、0.39、0.44、0.23)。 结论 主动脉夹层术前是否累及主动脉瓣病变对主动脉夹层支架及以远降段的病变无明显影响。主动脉瓣置换术后早期抗凝对DeBakeyⅠ型主动脉夹层残余假腔重塑效果无明显影响。

关键词: 主动脉夹层, DeBakeyⅠ型, 抗凝, 残余假腔

Abstract: Objective To investigate the effect of anticoagulation on the remodeling of residual false lumen after aortic valve replacement of DeBakey type I aortic dissection. Methods Clinical data of 31 patients with DeBakey type I aortic dissection treated during Oct. 2014 and Jun. 2015 were retrospectively analyzed. The patients were divided into two groups, that is, group one(n=20)who underwent surgical repairs with total arch replacement and modified stented elephant trunk technique(Suns Operation), and group two(n=11)who underwent surgical repairs with Suns Operation and aortic valve replacement. About 3 to 6 months after surgery, aortic CT angiography was performed to measure the diameter of the true lumen and aorta in the level of the initial, middle and end of the stent, celiac trunk, superior mesenteric artery and renal artery in each phase. The pre-operation and postoperative ratios of true lumen and aorta were 山 东 大 学 学 报 (医 学 版)54卷12期 -王龙,等.主动脉瓣置换术后抗凝对DeBakeyⅠ型主动脉夹层残余假腔重塑效果的临床影响 \=-calculated, respec-tively. In addition, the false lumen thrombosis was observed. Results There was no significant difference in the preoperative ratio of the true lumen and aorta diameter in the levels of the initial, middle and end of the stent, celiac trunk, superior mesenteric artery and renal artery(P=0.30, 0.94, 0.96, 0.54, 0.83, 0.49)between the two groups. After surgery, there was no significant difference in the ratio of the true lumen and aorta diameter in the 6 levels(P=0.28, 0.16, 0.28, 0.39, 0.44, 0.23)between the two groups. Conclusion Whether the aortic valve is involved has no difference in the lesions of stent and distal aorta. Anticoagulation therapy after aortic valve replacement has no significant effect on the residual false lumen remodeling of DeBakey type I aortic dissection.

Key words: DeBakey type I, Anticoagulation, Residual false lumen, Aortic dissection

中图分类号: 

  • R654.2
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