中国实用外科杂志 ›› 2008, Vol. 28 ›› Issue (07): 569-570.

• 论著 • 上一篇    下一篇

马凡综合征合并降主动脉瘤16例治疗分析

赵洋1王玉琦2符伟国2   

  1. 1上海交通大学附属胸科医院胸外科,上海200030;2复旦大学附属中山医院血管外科研究所,上海200032
  • 收稿日期:2008-02-01 修回日期:2008-04-20 出版日期:2008-06-24 发布日期:2008-06-24
  • 通讯作者: 赵洋

Surgical treatment on Marfan syndrome accompanied with descending aortic aneurysms: an analysis of 16 cases

ZHAO Yang,WANG Yu-qi,FU Wei-guo.   

  1. Department of Thoracic Surgery,Shanghai Chest Hospital Affiliated to Shanghai Jiao Tong University,Shanghai 200030 China
  • Received:2008-02-01 Revised:2008-04-20 Online:2008-06-24 Published:2008-06-24

摘要:

目的:总结马凡综合征合并降主动脉瘤的外科治疗经验。方法:回顾性分析复旦大学附属中山医院血管外科1998-2005年治疗16例马凡综合征合并降主动脉瘤的临床资料。结果:12例行腹主动脉瘤切除人造血管移植术,2例行开窗术,2例行人工血管腔内治疗。围手术期内死亡2例。13例(81%)随访4个月至7年,其中1例因发生胸主动脉夹层破裂而猝死,伴有高血压的10例病人中有6例术后血压恢复正常,另4例需口服药物后方可控制血压;另2例情况良好。结论:马凡综合征合并腹主动脉瘤的动脉管壁结构比一般病人更加薄弱,Bentall术后仍有夹层动脉瘤复发的危险;对该类病人应首先考虑传统手术,以尽最大可能切除病变血管,腔内治疗的应用指征有待进一步探讨。

关键词: 马凡综合征, 主动脉瘤, 主动脉夹层

Abstract:

Objective:To summarize the surgical experiences in Marfan syndrome accompanied with descending aortic aneurysms. Methods:The clinical data of 16 cases of Marfan syndrome accompanied with descending aortic aneurysms admitted between 1998 and 2005 in Shanghai Chest Hospital Affiliated to Shanghai Jiao Tong University were analyzed retrospectively. Results:All the 16 cases had history of Marfan syndrome and 2 of them had an additional experience of Bentall operation.All the 16 cases underwent operations,including traditional operation in 12,fenestration in 2 and endovascular treatment in 2.Two cases died postoperatively and 1 of them died on the 10th day after the endovascular therapy.Thirteen cases were followed up for 4 months to 7 years,of which,1 died of rupture of the thoracic aortic dissection suddenly,and 2 were excellent.Six of 10 cases with hypertension preoperatively showed normal blood pressure,and the other 4 were controlled by medicine. Conclusion:The aorta wall structures of the aneurysms accompanied with Marfan syndrome are more fragile than the normal patients and though a Bentall operation advanced.There is even likely recurrence of dissections and aneurysms.It could be treated with traditional operation primarily and the indication for the endovascular technique should be further discussed

Key words: Marfan syndrome, aortic aneurysms, aortic dissection