摘要目的:比较自体心包垫片技术与三明治技术在急性A型主动脉夹层(AAAD)根部吻合中的围手术期及1年随访效果。方法:分析2021年1月至2023年12月期间接受标准孙氏手术的133例AAAD患者，按入院时间分为自体心包垫片技术组(68例)和三明治技术组(65例)，比较两组的手术时间、术中红细胞输注量、术后24 h引流量、辅助通气时间及术后1年随访结果。结果:自体心包垫片技术组手术时间低于三明治技术组[(421.0±71.0) min比(482.0±91.5) min， P<0.05]，自体心包垫片技术组术中红细胞输注量低于三明治技术组[(3.0±2.2) U比(4.2±2.7) U， P<0.05]，自体心包垫片技术组术后24 h引流量低于三明治技术组[(297.0±18.4) ml比(354.0±43.9) ml， P<0.05]，自体心包垫片技术组辅助通气时间低于三明治技术组[(32.9±4.4) h比(35.8±3.5) h， P<0.05]。 结论:自体心包垫片技术在AAAD根部吻合中具有显著优势。

abstractsObjective:To compare the perioperative and 1-year follow-up outcomes of the autologous pericardial patch technique versus the traditional sandwich technique in root anastomosis for acute type A aortic dissection (AAAD).Methods:A retrospective analysis was conducted on 133 AAAD patients who underwent standard Sun’s procedure between January 2021 and December 2023. Patients were divided into the autologous pericardial patch group (68 cases) and the sandwich technique group (65 cases) based on admission time. Operative time, intraoperative red blood cell transfusion volume, postoperative 24-h drainage volume, ventilatory support time, and 1-year follow-up outcomes were compared between the two groups.Results:The autologous pericardial patch group had significantly shorter operative time [(421.0±71.0) min vs. (482.0±91.5) min, P<0.05], reduced intraoperative red blood cell transfusion volume [(3.0±2.2) U vs. (4.2±2.7) U, P<0.05], decreased postoperative 24-h drainage volume [(297.0±18.4) ml vs. (354.0±43.9) ml, P<0.01], and shorter ventilatory support time [(32.9±4.4) h vs. (35.8±3.5) h, P<0.01]. No significant differences were observed in the 1-year follow-up outcomes between the two groups. Conclusion:The autologous pericardial patch technique demonstrates significant advantages in AAAD root anastomosis, including shorter operative time, reduced intraoperative red blood cell transfusion, decreased postoperative 24-h drainage volume, and shorter ventilatory support time, with favorable 1-year follow-up outcomes.