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胸大肌肌瓣翻转成形术治疗急性Stanford A型主动脉夹层术后<br />胸部切口感染的体会

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摘要:

目的 探讨胸大肌肌瓣翻转成形术治疗急性Stanford A型主动脉夹层术后切口感染的治疗体
会。方法 回顾性分析2012年1月至2020年12月于解放军总医院第七医学中心心脏大血管外科住院的急
性Stanford A型主动脉夹层术后胸部切口感染的30例患者的临床资料,其中男性19例,女性11例;年龄
38~79岁。结果 手术治愈20例,术中人工血管破裂出血死亡1例,术后伤口未愈合形成慢性窦道9例。1
年后随访29例,20例伤口愈合患者中复发5例,形成慢性窦道,其中1例术后并发菌血症感染死亡。其余
15例均无复发。结论 早期使用胸大肌肌瓣翻转成形术治疗急性Stanford A型主动脉夹层术后切口感染能
较好地促进患者切口的恢复,改善症状,提高生存率。

Abstract:

Objective To discuss the treatment of chest incision infection after treating acute Stanford type
A aortic dissection with pectoralis major muscle flap flip plasty. Methods The clinical materials of patients (n=30)
with chest incision infection after treating acute Stanford type A aortic dissection were retrospectively analyzed from
Jan. 2012 to Dec. 2020. Of all patients, there were 19 male ones and 11 female ones aged from 38 to 79. Results
Among all patients, there were 20 cured with operation, 1 died due to rupture of artificial blood vessel during the
operation, and 9 with chronic sinus tract due to unhealed wound after the operation. One year later, 29 cases were
followed up, and 5 of 20 with wound healing had recurrence and suffered from chronic sinus tract, among them
1 died of postoperative bacteremia infection. There was no recurrence in other 15 cases. Conclusion The early
application of pectoralis major muscle flap flipping for treating postoperative incision infection after acute Stanford
type A aortic dissection can promote incision recovery, relieve symptoms and improve survival rate.

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