Is it justified to apply a modified Cabrol fistula in surgical repair of acute type A aortic dissection?
Is it justified to apply a modified Cabrol fistula in surgical repair of acute type A aortic dissection?
复制标题
在急性 A 型主动脉夹层手术修复中应用改良的卡布罗尔瘘是否合理？
DOI：
10.1016/j.jtcvs.2018.12.082
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发表时间：
2019-11-01
影响因子：
6
通讯作者：
Chen, Liang-wan
中科院分区：
文献类型：
--
作者：
Zhang, Hui;Wu, Xijie;Chen, Liang-wan
目的：急性A型主动脉夹层切开修补术常导致缝合线渗漏。一种改进的瘘管技术被开发出来，以快速控制渗出，并允许立即安全地关闭胸腔。评估这种改良的瘘管技术在急性A型主动脉夹层手术修复中的有效性。自2015年1月至2016年12月，172例急性A型主动脉夹层患者在我中心接受急诊手术修复。其中76例采用改良Cabrol造瘘术(造瘘组)，其余未采用改良Cabrol造瘘术(无造瘘组)。结果：两组患者的术前资料、体外循环时间、主动脉阻断时间、选择性脑灌流时间、下体停搏时间相似。瘘管组的胸廓关闭时间较短。术后引流量、红细胞输注量、再次开放止血发生率、机械通气支持时间、重症监护病房住院时间、术后透析发生率、30d病死率均明显低于无内瘘组。结论：改良Cabral内瘘技术在急性A型主动脉夹层修补术中能迅速控制渗漏，有效改善近期疗效。
Objective: Open repair of acute type A aortic dissection frequently results in oozing from the suture lines. A modified fistula technique was developed to rapidly control oozing and allow closing the chest immediately and safely. The efficiency of this modified fistula technique in surgical repair of acute type A aortic dissection was evaluated.Methods: This was a retrospective study. From January 2015 to December 2016, 172 patients with acute type A aortic dissection underwent emergency surgical repair in our center. Among them, 76 were treated with the modified Cabrol fistula technique (fistula group), and the others did not receive this modified technique (nonfistula group). The clinical data of all patients were retrospectively reviewed and analyzed.Results: The preoperative data, cardiopulmonary bypass time, aortic crossclamp time, selective cerebral perfusion, and lower body arrest time of the 2 groups were similar. The chest closure time was shorter in the fistula group. The postoperative drainage, amount of red blood cell transfusion, incidence of reopening for hemostasis, mechanical ventilation support time, duration of intensive care unit stay, incidence of postoperative dialysis, and 30-day mortality were significantly lower in the fistula group than in the nonfistula group.Conclusions: During surgical repair of acute type A aortic dissection, a modified Cabral fistula technique can rapidly control oozing and effectively improve the short-term outcomes.