摘要近20多年来,我国急性Stanford A型主动脉夹层诊疗取得了飞速发展,主要得益于三方面的进步,分别是在Stanford分型的基础上提出了我国主动脉夹层的细化分型,右腋动脉插管心肺转流及选择性脑灌注技术成为Stanford A型主动脉夹层手术心肺转流基础策略,全主动脉弓替换及降主动脉支架象鼻人工血管置入术(孙氏手术)成为治疗Stanford A型主动脉夹层的标准术式.然而,我国主动脉夹层诊疗工作还存在诸多问题亟待解决,主要为“不规范”“不成熟”“不及时”,即缺乏完整全面的、能够体现主动脉夹层诊疗特点的规范或指南,围手术期器官保护和术中血液保护技术仍有较大缺陷,患者从发病到手术所需时间较长.我国急性Stanford A型主动脉夹层的诊治任重道远,只有汇聚更多同仁的才智与力量,才能取得进一步的发展,让更多患者受益.

abstractsIn recent 20 years,the rapid development of acute Stanford type A aortic dissection in China has been mainly due to three aspects:(1) the refined classification of aortic dissection based on Stanford classification,(2) right axillary artery canal and selective cerebral perfusion technology become basic cardiopulmonary bypass strategy for Stanford type A aortic dissection,and (3) total aortic arch replacement and descending aortic stent graft surgery (Sun's surgery) become the standard treatment of Stanford type A aortic dissection.However,there are still many problems in the diagnosis and treatment of aortic dissection in China,such as:(1) unstandardized,lack of comprehensive guidelines of aortic dissection,(2) immature,perioperative organ protection and intraoperative blood protection technology remains a big flaw,and (3) it takes a long time to get patient prepared for surgery.In conclusion,as to the issue of the management of acute Stanford type A aortic dissection,there will be a long way for Chinese doctors to go.Peers should pay more attention to this problem and take more efforts,so that the outcome of acute Stanford type A aortic dissection surgical patients can be improved.