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find Keyword "主动脉瘤" 89 results
  • Pathogenesis and Therapeutic Prospect of Abdominal Aortic Aneurysm

    Objective To investigate pathogenesis and therapeutic prospect of abdominal aortic aneurysm (AAA). Methods  Relevant literatures about pathogenesis and ways of treatment for AAA in recent years were reviewed. Results The formation of AAA are associated with heredity, anatomy, environment and biochemistry and other factors. All factors influence and interact with each other. The metabolic disequilibrium of aortic intermediate extracellular matrix plays an important role in the pathogenesis of AAA. The main reasons for the formation of AAA may be the increase of activity of matrix metalloproteinases and the disequilibrium of genetic expressions of elastin and collagen. The therapy of AAA includes surgical and medical treatment. The methods of medical treatment are still in the process of exploration and research. Conclusion The formation of AAA is a synergistical result of multiple factors, and medical treatment is an important supplement of surgical treatment.

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  • 胸主动脉瘤及主动脉夹层外科治疗进展

    胸主动脉瘤及主动脉夹层病情凶险,死亡率和病残率均很高.近几年在保留和不保留主动脉瓣的主动脉根重建术治疗升主动脉瘤,弓部主动脉瘤切除与脑保护,胸主动脉瘤或胸腹主动脉瘤切除与脊髓保护,以及主动脉腔内支架移植术等方面取得了较大的进展.手术死亡率已从31.4%下降至3.3%~4.8%.胸主动脉瘤,特别是主动脉夹层系一全身性主动脉病变,近年来手术疗效有所改善,但远期复发率和再手术率仍较高.主动脉内支架移植与外科手术结合应用,对复杂的伴有降主动脉病变的A型主动脉夹层治疗,可能是一种安全而有效的方法.

    Release date:2016-08-30 06:30 Export PDF Favorites Scan
  • 升主动脉瘤合并主动脉瓣关闭不全外科手术后早期处理

    目的总结升主动脉瘤合并主动脉瓣关闭不全患者手术后早期处理的经验。方法21例患者术前心功能(NYHA)Ⅳ级15例,Ⅲ级6例;施行Bentall手术19例。Cabrol手术2例。结果全组无早、晚期死亡,术后早期发生心律失常和出血等并发症2例。术后21例均行超声心动图检查,4例行逆行主动脉造影示主动脉瓣关闭良好,移植的带瓣管道通畅、无扭曲。随访0.5-11年,平均4.5年;无动脉瘤复发,效果满意。结论术前严格掌握手术适应证,升主动脉瘤直径大于6cm应及时随访和做预防性手术,一旦发现夹层动脉瘤应立即手术;术后及早发现、纠治心律失常和出血等并发症,早期用抗凝治疗,可提高手术成功率。

    Release date:2016-08-30 06:26 Export PDF Favorites Scan
  • COMPARISON OF ENDOVASCULAR REPAIR AND OPEN REPAIR FOR RUPTURED ABDOMINAL AORTIC ANEURYSM

    Objective To compare the effectiveness between conventional open repair (OR) and endovascular repair (EVRAR) for ruptured abdominal aortic aneurysm. Methods Between March 2000 and July 2011, 48 cases of ruptured abdominal aortic aneurysm were treated by conventional OR in 40 cases (OR group) or by EVRAR in 8 cases (EVRAR group). There was no significant difference in age, sex, the neck length (less than 2 cm), the neck angulation of aneurysm (more than60°), il iac severe tortuosity, preoperative systol ic pressure, and preoperative comorbidity between 2 groups (P gt; 0.05). The blood transfusion volume, operation time, intensive care unit (ICU) stay, postoperative complications, reinterventions, and mortality were analyzed. Results There was no significant difference in 24-hour and 30-day mortality rates and non graft-related complications between 2 groups (P gt; 0.05). EVRAR group was significantly better than OR group in blood transfusion volume, operation time, and ICU stay (P lt; 0.05), but OR group was significantly better than EVRAR group in reinterventions and graftrelated complications (P lt; 0.05). Conclusion EVRAR has obvious advantages in blood transfusion volume, operation time, and ICU stay, so it is feasible for ruptured abdominal aortic aneurysm in patients with precise anatomical suitability.

    Release date:2016-08-31 04:23 Export PDF Favorites Scan
  • Clinical Analysis of Ruptured Abdominal Aortic Aneurysm (Report of 6 Cases)

    目的 探讨腹主动脉瘤破裂的诊断和治疗方法。方法 我院从1999年10月至2004年1月期间经手术治疗腹主动脉瘤破裂6例。结果 1例患者因术后失血性休克而死亡; 5例患者随访4年,1例术后2年死于心肌梗死,余4例存活。结论 腹主动脉瘤应早期诊断、早期治疗,一旦破裂应迅速诊断、急诊手术,手术时应注意阻断腹主动脉的方法以及防止术后下肢缺血。

    Release date:2016-09-08 11:49 Export PDF Favorites Scan
  • 升主动脉和弓部动脉瘤的外科治疗

    目的 总结升主动脉和弓部动脉瘤手术治疗经验,以期进一步提高手术疗效. 方法 自2000年7月至2002年5月应用深低温停循环(DHCA)和上腔静脉逆行脑灌注(RCP)技术手术治疗升主动脉和弓部动脉瘤20例,其中急症手术5例.施行全弓置换术2例,全弓置换和象鼻手术3例,半弓置换术15例.同期行Bentall手术8例,升主动脉置换术或同时行主动脉瓣置换术12例,冠状动脉旁路移植术1例. 结果 术后早期死亡1例,短时间浅昏迷1例,呼吸功能不全2例,肾功能不全2例,无晚期死亡. 结论 DHCA和RCP技术是手术治疗升主动脉和弓部瘤的安全、有效方法,急性A型夹层动脉瘤的手术方式取决于内膜破裂口的位置;正确掌握DHCA和RCP技术、手术方式和手术技术、围术期处理是提高手术疗效的关键因素.

    Release date:2016-08-30 06:30 Export PDF Favorites Scan
  • Type Ⅱ endoleak originating from inferior mesenteric artery after endovascular abdominal aortic aneurysm repair: A retrospective analysis in a single center

    Objective To investigate the management experience of type Ⅱ endoleak originating from inferior mesenteric artery (IMA) after endovascular abdominal aortic aneurysm repair (EVAR). Methods The clinical data of patients with type Ⅱ endoleak originating from IMA after EVAR treated in the Department of Vascular Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University from October 2016 to November 2021 were collected and analyzed. Results There were 12 males and 3 females at age of 57-89 (68.00±7.84) years. Eleven patients received embolization of the abdominal aortic aneurysm lumen and initial segment of the IMA via the superior mesenteric artery-middle colic artery-Riolan arch-left colic artery-IMA route. Three patients received embolization of the initial segment of the IMA by the above route. One patient underwent open dissection of the abdominal aortic aneurysm, and orifice of IMA was sutured in the aneurysm cavity while stents were retained. All 15 patients were successfully treated by surgery. The symptoms of back pain, abdominal pain and abdominal distension disappeared in 6 patients after surgery. Neither perioperative deaths nor complications happened during the treatment and follow-up period. The median follow-up time was 11.00 (9.00, 18.00) months. Two patients with typeⅡendoleak recurred during the follow-up period and were admitted to hospital for secondary embolization. No recurrence was observed at 12 months postoperative follow-up. Conclusion Type Ⅱ endoleak is one of the most common complications after EVAR. IMA is the most common criminal origin of typeⅡendoleak. TypeⅡendoleak that lead to persistent expansion of the aneurysm cavity requires aggressive intervention.

    Release date:2024-09-20 01:01 Export PDF Favorites Scan
  • Application of Cannulation of Right Auxiliary Artery during Ascending Aorta or Aortic Arch Replacement

    Objective To introduce alternative approach of right auxiliary artery cannulation through a 8 mm hemoshield graft for cardiopulmonary bypass and selective antegrade cerebral perfusion. Methods Twentythree cases of acute type A dissection and 7 cases of ascending aortic aneurysm, in which aortic arch was involved, were evaluated. An 4-5 cm long incision beneath right clavicle was made to expose auxiliary artery with auxiliary vein and brachial plexus intact. An 8 mm hemoshield graft was anastomosed to auxiliary artery and connected to the arterial end of cardiopulmonary bypass circuit. The auxiliary artery cannula was used for arterial perfusion and also used for selective antegrade cerebral perfusion. Fifteen total arch and 15 semi-total arch replacement were performed. The graft connecting auxiliary artery was simply ligated when cardiopulmonary bypass was concluded. Results Arterial perfusion flow and pressure through auxiliary artery were not significantly different from that of cannulation via ascending aorta. No significant postoperative cerebral deficits and complications of right upper limb associated with cannulation of auxiliary artery occurred. Conclusion Arterial perfusion through right auxiliary artery provides an excellent approach for surgery of acute type A dissection and ascending aortic aneurysm with optimized body perfusion and allows for antegrade cerebral perfusion during circulatory arrest.

    Release date:2016-08-30 06:10 Export PDF Favorites Scan
  • Analysis of protein differences in aortic aneurysm/dissection based on tandem mass tag proteomics

    ObjectiveTo analyze the differences in proteins between aneurysm/dissection patients and healthy subjects, and subsequently figure out differential proteins related to medial degeneration of aortic aneurysm/dissection.MethodsAortic wall samples were collected from 6 male aortic aneurysm patients (an aortic aneurysm group, mean age 56.50±8.19 years), 6 male aortic dissection patients (an aortic dissection group, mean age 54.17±6.68 years) and 6 male healthy subjects (a normal group, mean age 40.50±9.31 years) between December 2019 and May 2020 in West China Hospital of Sichuan University. Quantitative proteomics was performed using tandem mass tag (TMT) techniques, followed by gene ontology (GO) analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis.ResultsA total of 63 differential proteins were obtained both in the aortic aneurysm group and the aortic dissection group compared with the normal group, with 30 up-regulating and 33 down-regulating. The differential proteins were involved in multiple biological processes and clusted on peroxisome proliferators-activated receptor (PPAR) signaling pathway, extracellular matrix-receptor interaction signaling pathway and complement and coagulation cascades signaling pathway.ConclusionThe identified proteins may help to demonstrate new molecular mechanisms related to medial degeneration of aortic aneurysm/dissection.

    Release date:2021-10-28 04:13 Export PDF Favorites Scan
  • 腹主动脉瘤破裂患者的急救及护理对策

    【摘要】 目的 总结对腹主动脉瘤破裂患者的急救措施及护理对策。 方法 回顾分析2004年1月-2008年2月收治的11例腹主动脉瘤破裂患者抢救及护理过程。 结果 6例患者治愈出院,5例死亡,其中术中失血性休克死亡1例,术后消化道大出血及多功能器官衰竭死亡2例,放弃治疗出院后死亡2例,存活率为54.5%。 结论 通过对腹主动脉瘤破裂患者采取及时有效的抢救配合及护理措施,有效地提高了手术的成功率及生存率。

    Release date:2016-09-08 09:51 Export PDF Favorites Scan
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