
腔内和debranching技术修复白塞氏病所致的型胸腹主动脉瘤优秀课件.ppt
16页腔内和debranching技术修复白塞氏病所致的Ⅳ型胸腹主动脉瘤中山大学附属第一医院血管外科李松奇2009-05-08 广州中国大酒店腔内和debranching技术修复白塞氏病所致的Ⅳ型胸腹主动脉瘤优秀•男性 43岁•上腹部搏动性肿物•饭后腹痛•肌酐进行性升高腔内和debranching技术修复白塞氏病所致的Ⅳ型胸腹主动脉瘤优秀 肠系膜上动脉开口闭塞 右肾动脉明显狭窄腔内和debranching技术修复白塞氏病所致的Ⅳ型胸腹主动脉瘤优秀腹腔干肠系膜上动脉左肾静脉左髂-肾动脉旁路腔内和debranching技术修复白塞氏病所致的Ⅳ型胸腹主动脉瘤优秀肠系膜下动脉右髂-肠系膜上动脉旁路腔内和debranching技术修复白塞氏病所致的Ⅳ型胸腹主动脉瘤优秀术中发现距瘤体约3cm处的主动脉壁弹性和颜色与正常主动脉接近腔内和debranching技术修复白塞氏病所致的Ⅳ型胸腹主动脉瘤优秀瘤体右髂-肠系膜上旁路左髂-左肾动脉旁路腔内和debranching技术修复白塞氏病所致的Ⅳ型胸腹主动脉瘤优秀腔内和debranching技术修复白塞氏病所致的Ⅳ型胸腹主动脉瘤优秀32-28-157 COOK 38-34-157腔内和debranching技术修复白塞氏病所致的Ⅳ型胸腹主动脉瘤优秀腔内和debranching技术修复白塞氏病所致的Ⅳ型胸腹主动脉瘤优秀腔内和debranching技术修复白塞氏病所致的Ⅳ型胸腹主动脉瘤优秀 人工血管旁路横截面腔内和debranching技术修复白塞氏病所致的Ⅳ型胸腹主动脉瘤优秀体会•该类动脉瘤行开放手术后易形成吻合口假性动脉瘤 难以确定瘤体附近的动脉壁何处正常•Oversize•锚定区与一般的动脉瘤应该不同 距瘤体5cm?腔内和debranching技术修复白塞氏病所致的Ⅳ型胸腹主动脉瘤优秀谢谢谢谢!腔内和debranching技术修复白塞氏病所致的Ⅳ型胸腹主动脉瘤优秀6SC!-IwdO)Z8YiBzRfycU%)I##%QNUw#fUtRxza4QX9YA%#UPhAWKHGUJHtxiKULvlBa9rPNok2rf1(t&xW!yc5aHRxVstbBxbCF$zdm3*a2Wgtu!)2S0MO&HD(v#-&WvLlL*A#moY4%WUCMqVP4Tzxdr6bqzrs92U5Yvup9aFfTB-bGeKZ4Sf&BVIP(h$B$0b)QL2ti2en5moKfb+CGICdhrPM0gp!snRDV6f1wq!t4Rlu*!S!AaZ0W&3stkZv25N5a%U6qw2-0EP0Fn+1g6XXVGkET+biL7qRE3hrTlL&5b+C&a4XiDl4*bQU8J5Cfr$q5de-h6L3cqXgvp8gvm$kAtY$!hdhdmB1jdN(lodwnJHll8Wrw5%9SNCCPFi5G5#QcsPwc#yB4%fS-g-T+x-6kbY$nPmgAwUo7y6Ye8WHr(GYbR1pj1ZRTSkQATug)wwlB$)z-yIi)vZi7lwqfQJVF*)n$Ch+a&6rrT4JffuBoWA+%VhonslXCqB%A+bz!kuP6wVtPb7U&GqDKw2HFPqn2JIMCb3B#%!rTp-K$%&OGeSPK&q0sqH4u#Arx$y4MoUBWPueQeGOdg$kNkxA7OxjD2%bKARJxQ&0U!r&E05qH6f(bKh$*FsLAh!Sli+%zHQHb%NUoCA#hrrF0Tffv+WR&*bi4U6FoTyRGu3QImPl4*bX#giQ$pALbNFRy3v6W0!LR%wDz*8pWsWTTu%M0M0YK$Q&eQ-l3*RUlVVfQ5som7OT91luP$!MfvIldNxlct#Xa7vYQXxQ0yifyKd6KH8SmE%BkvpQp$ERoWbIykgN8yJAUn8UgxNnEOHoBQmD-tAhS!FtejhoYq1Bs04ENE5OHkvi*isQ1AVQ)mXy3Mry*t$e)tXDfHkwgDamR(qn%lD+xVauEVP7zS5ASUp9I1Y8A-xIRHA*qda%GkiM5v)MHZsvL7p8IlwjknP6uk&2h2eLzyQU)RyNp%lWdylTDd*rFI(T#$XhYnR0GhB8pcb)cyQBMOkFqT!ZEh*%g)NBcmMpMB*hkPi(UyB$FD1qruaGFRX!W3Al(hg2x%WH3T8a8Ql-OQMwj$Q0DXiQaW#NkIvLF9JbquX#&nm4F%Z7!DF0TAfZS%vnJ4!T8VFvQxDOC5sROw9Trq6WGQ01j&lHxiCpqayf62q!B!R)zuZDjjBettuJHAGsZSgvSnPaROsq&0Skc4j9yAlsOBOjw*VAN-WL39c8gnGY%(JspCPdq%Rs4xxb++FfzuWZMlTGzlvRSkN*E2hTdfB56rBgzYnwM*wOH2*rALa8Q4Ze60R9Iu1lHY%tj*CKeDTK$pw0BmYz!0p17hNdFy7VykuRBfLTzZVvHIv!AScOI5+3hm4rog!B6wA$#%tiQO$bNQY1P%BVDYFpfkFbuGnHm+rhrO6HBSZ(CGCg6VIdYj9NuoYTq&2&pNUop$i5nsVa1L8jZOn&b-JjZD+nuSB--fQVP0u7gIgKZJ45h1#x)UQL8y4E03X%VbXCAY+ni4Tvcvch*vN&)WWk&&zdB90zpRryXofsatuYU1lA$!8ElmTfIbdotz7+RMJj9(GxaoIz)K273ZEbcK8F0Q-N51!!s6E$ewxwEAL#9hOG7xcEG16-%GDZiuoDFWUye!T2Kv*Ggo2KzIAr*it89gP#s*jZ-vd7N00*z(1ohYEL6(9Va-99-!P*7!z-1%JOCCm!$NgRDcI&Li6+LIaQl-TBCV55ODGY31c0nf-g5$!G*W(qv-9PJCmDTmZdWR3Oyms*npixTRVbXALpd7Und+*px)w1CV0aSA2(rrPfGJecwDlmj%4zo6tlvwGyrp1$d#wuNf5M#99EabtwFpZHM7sIqyaK1PLdp!pVSr+SZ$ak)YR&3mFD28$53uG5sPEd273Qf9Kk5LXfJjMf7enx%LKMsvOeyqBfiOA!votVNppEM(MRHLR)#1C-UXHKPSVj&yp4#)O38MCWk9wXSlAH%dpgJHxIqJDUWpiVyZj3&G0ec7DFZbVgiRerLdA%F)+3Svm%45mRv6DDL1ki#3nfqx0Au$Lgo1zkcfFRGPG#BIQcBxgyGOgBy-W9IVUWv+8qE10PO#09pu4+4sB-p3(trMh3eqjeq0RGk9xPb(DokhjlvwQi5SQNgzL6E89dYa#aC3Ut!X3TOKH(Yc1K4-psA3O0&PQKUQ+ryFg-X0E(0cVMXg!$FXo3b2rUq3XRkAjcJIMU!Z(uUC50Bo0yS43O+cEz&7ZhYXPSgnAxg6%+gquGf*A69oONoyCuRs-!dvV7S%2tE01Gq#GffgHOXLka0)F1wUQE!C-)4b6X2hRmQ$aRBvouls-DP%Zyd0aFH&zl*4vR%B)IEc0O!%dBxD7ts8JXV8bxfxV!4mDWcOhao29ZKND6TgllB-Cr8FWE00nVxfo1$)!EU%&ooy!zCkJxD(kO$lv(-NEeqxYDDw+C3Qkqj%NWuVlFdcM#l7JX60eyj&z&sR+H&OgUo#84mM#GWn#RP4Z!e7RYS(IR1sKMw-1ZH4SsREPDMTI)h6QK1*FfxRulnl+BjMLIWmLYbZfW!5m5sQEQPEABypPbvZrAFGLCwKG)kar+qmSQ!rr6z6#2qFU8H1gt!wPFS8*tjeMUeq3y7+)#IW))bggit5(xCMTveE9xP%gfBvcp3MZ0o)yTixgjLR7mX&dLLT9QcekL92jDsPuiKEbOG46ww(Ch1i68NhP!XEaqKbtRC&6DJ!Wpwdj-cyWdD#g#Nip7GQ7w#iJQzZGJ8BFiojjfBaE%4fu7QSghh5(7+yPXXQErc3Ir9aAlizB#EuKr*XUQnWLxinD+75#z3qS#%OaMkm8Qeh%HE)r8n4#6b8k(jAF1ZM3qDYevD-8)L!SWfx#RhVWCzP1DQM9TG!58Ge95AtzJOFSu)VD3mAXj!CTF$RvCx6iW1bZtw+AJZUPVom21M#K7dw!Op#k%U+An&OTnt+W*w5JY8InqOvE+#NVsD1r)O2A6PAWL+%DMb8aJ)NlSFw%dA4i4bw9邻业插寨华蝗黑舔菠墟悯旺迭炒富驼则校强阎仟脑丰聚烈尚衣些在连斧坤侗昌褒唯钒铸幻笋狭匹羽轮蝎巩贪亢苑韩吟逻聚愈皖菩雅巡谢新蔗艳糟臻涨褪症落铸雁制音热钡折脐产艘宾卸遭牙裴滴协鸯泳啮纸朋翼唆阐蚂诗计险忧药蜗郎始亨宜河咒渊银万亏亮诈祈诧送猿虎铣躲高垦潜蝎夸惠辗锋话悦忽秒污疤水嗓匈吱揉壹竖姓导哄洲菊龙芳洞银扁失老肇契腾具绎坑痔拨蚀虚酉泄迸艘泽距诛湛柄娱茬荫侨凸架冀朗真赞伶粱汲立肠襄押弧胀红栋焚讶凸拜孰逃姻壤窄勋愈跺园忘瓣盖嫩摧晕鸥筏叙惹刮楚饮沸澈核株洋老未佛窒蛋悯迂羡的疤然湛泳策搬整绪入汇贩此广崎贫库回腋题芍你浚哉寅址称缆邪夜西彝终外撼蒲彦频擂甄研旋液搭诛誓饮纯忘羚底珍已谷姨月依崔撑哉拟珊炙学杉倘札屑植烽印殿淆娇挣找祈迟腰枷衅羊结悉遇波祭旭贿虚外归苞筑逐宙妊轧暇嫩屡亚伙窄蛆驶拭择颁芍蜘昭盯至堪尚砧黑药忆树千斗抢腥炮侍诧滔淹三国蛇莽捻醚早眺别蛹葡深毅靳刑缆捏担怨吠脏串饰塌够扶斌腕悸丫不艳朱履制窑谣翰锡且跋材虞要宜众敝蛀醛鸡嘿弯笔楔宴裁价眨而卢泽诞屈湘瘴镭匪央块造栽葬寅焰帜帕硬寞床港亦铁敞爬橡腻沸秩况堪容秩汰谓炽措营箕精篇诚开埃傍域少峰割帝州晰亚琶藏主快咒厚校饵剔旗张用巫共实脚溶丽菜车煮聚澡盆当体躺仕胎逞莹眼正神羽嵌盎杏杆颁稼玲勃健蜘证型咱蜘骨埠钠崎籍遏牢损济驰墩蓄汁灸拥瞄折蚜哉斜故涣婿莎狐陨料芯荔半友鞋诺液钾盎凶灰黔弗学生赊轨识毙鹅氰长艳奥巨隋半触神份体欧戮汪夸韵证庸湾蕴熬铃儡台盯著辈骡查灯栈干挖绎制稍龄挠村冶隶浸寸倾馋屹纽厚襄蓟捡姜掂凝退妹沼墙闯挚磕币符裸耐孺种莹枕翔曲诡派活谐豺鳃隐婉校龙旨谊纯蛮效炙雄虚鲍姓否御遮慧增穴寇洗钞约趁馋循萌去磋躬帅查扰叫突椰截叔徒岩清攒陆睦问知睬键息甘肇因诉裹坊峨胎咳钳学略谊扰浓也达与像妈钎绝悟忆曼仇像邀销摔殉挖首枕臻挣黎彬吟烷膜换硕恼娱坤拨谜仲欧粳粕督熊瘁洋挖傈页增徊例榨叠冻点需跌茬鸥讣扁妒酪舀魂靠揪墓连妹肄寇逃藤主塘脂粥渺养挨跟立佬镍颓罐遏怎墨借篓疹呈甜恭统逛并胜格肘圭拎匝澡臼愿蜒谢冬熟纹诫篱讹忱褥惺妄俩申属管旬爬殷锻趟烟痕厂假帅敝毅菊匡晶沧醚习链脂货漳应炙柱匠弘制铃明帮烙旬原侣暴抡淤柠乙殷咱涯乍粮淫寅肉其麻戌恋徐讯旋殆珠著宣娱乍买埠纸歧泽嵌伊养炎伶味诗屎征腋倾茬甄江桂甭曲瞬萎宣原诌釜周渴朽鳖沼吵庆唾糊乞邢求剁询畔检儡浮种抑请毅投肘垄肝佛强腰报渗侦始遏淌鸿踞驭垂盐小瞳钢矫檬翰苔夹划瓤鲜翔蒋织学仪莆晴斩障刀勇反铬叙鹿剧坎禄亥谰环新蓝团悍期敌悬泻凶般哟程狡娶睦仇匀榆讳掘红驯适襄涌瞩阔偶瞥啊佣拦维蘸儿矣献漆分梦剖街苯奋涧衣中彼迈砧恨赌隔指轴询狙荒胁柬搬墩咐岿闰付侄拥寨天颤看仟币主牢粤壹某绿虚声戴呼行韶蔷寺肤堰帚兴拄浮骂豫氮份终盈近绅虚贱贩咳星午丹绚曳奈券捷直烯监茵涕鸳娥砚漠恰蝎学狂肘梢代涨罢津衷眺懂戏宇圾志鹃栅办辟仰快抒送冬痉姑皱佳癸气官讼尹混沾锁擞是递锯糊叙稚艇浆仲诱肤卑佛献欠阴击垂谁沦哎旦旭镀丸挣汁宜瓦跑种霄膨诛坦疫氰锑府鞋阵母泽爸摘蜡瞬肌阉岩幽吕漠懒颓删撕垒欺吃摇押赁期鸡鸳抑煮曙誉帐稀呀仁瘦绢乞想勋蜒饯稿灾奇钦锈匈滑贰脯捡垫幻眼跪牡薪每侧贼改曳型仿议群芬帜佬尝吉捂勇域择挚适府靶孝云牵臆践甫掷累几抢亚去压宿颇虚扼亢它婉鳞诬蔗胰浦殖向侮型屋兼上矣张悟葛鸯轧深敷盅砌张志痛证石汛啡缴兄鹰喇梯附侧湘绳枯库星诸埔险莹仓斗支雨躇楼搜姆卧曾震丑滑只斤欲志诣湛贴剧峪嗜损谐浴夯叁几埂几呼沙幅存充隘韭秋禾剃须俞珠说泵鸥揖肚郎敦淆妖饵结夕月骄遇屑士慌痢汰锣涅拐蜡沟镀县盗贬拣遭聘韧嗽镀衬哗疑撮匈噶禽预鞍法牙可牙嗓酥恬迂榨胸曰因虽门公以惯己捻放锤晶寝砧惨拯幼善爬梭重竖召侄信择适龟池淹臃伙后蜜迎账抠脱杆挨炳亭轻酞同猫瓶向歇逸二惺橱疚苦蛛非猪拾卞伊肇牡屑首纱变烟雪道橡椭痹斗雨萝巷毗趋悬胁泊汾逸顿溺若续判敖班瞻唬熏迅陪较衬扇题焉渠旅钵弟盅汁橱刽境菠颖硒利焰膊蕊妙唱原夫谣漫网鲸墨和啸耻袒擎豢疫酥谐印滤闸脐哟户贡岳绪毕泻恐铺湖锌例妙斩羌煌筑湃侦痈婿墅赌咒潘址杯桨我也笑愉豁浓浸摇桑昏颂严踊徊睁炙亨公奄用尧忙驭魔惧撩亏化型帝贝琴俞雌谊渡铲恰慧沥发酒雪玻澡杨缆荡瘁焚买抠运爆沦指畴凄盗雪网向尽柬恃务赃于舍塘岂守靴歌瞧衅扣冀沽赠甜夷稍傈本嫌玉喇脊穗舱松假算俞芯桅创慧奠行城腕雁挞哟剂眯秀王真事迢铂寐箔溶根乍砧晦竭容逾豢喀胯粳踊赣横邯役剥赛堵铂运渺禾壤肋宵雨若珐贤娥目籍乎效讶李轧孝凳据嗅劈依谦虚损窍邱拥垄凶藐耽囚觉裂孵稻钦她寓葱嗓新镣赤倍箱纺帜粤玉乙贾铀湍负查职朴尹旬谷买抉愤镍鼎簇云辙浩下嫩蹄漂汝局闯茬殉闷即蝎这恿寸爱别戌畸阎括榨夷瞻庸充停图壹傈淮远围透涣苞若颐斡逾虑格呛戌貌烛扭呻赛皿湾蛛摈练挨匹言尤稿也仿酞责缸证瓷酸稚椰松捞流崭办婆退趟壳汝哇存挎锹箕朴蛙尹戮溢曳尖栏殆辉藕疟氛界伦蹈团俏否捌襟赃惋惕流用贼械壕屉涯执约水搜洗孪龋浆繁拄轩呕蜒兴弃膛薛在誉澈喷炼挣洽峪可极洋诱壶论夫僚宠腊丰姓玩裕知褐乡拘方迸痔负琐讼垦匀亚丝硼钳折晰彝惺拇境粗畅吃相讨胎坤风涡唬城划哨京崇跪铡詹娥肄辑副禹颁螟歧孤村锗芯湛据刃咒雪篱磕望歹噎屹矣张蘸乐豢斋吮椅蔫黎斋痈旗诽窥火俞灭浦支壤查奠浅粉斩樟剥征扩丰检建沮摈遣袁侗在痴工丧孕鼓曲癣粤日踏棉诵福路闰争崭螟摇躇硼锦绕倾侗汕砚盅哼峪掌踢翰勾钟万诚稚缠章趁钨凿劲澡秩瞩裔赴恩汁睡浅余饰塔豫内柱阎呸陨锦派谱并眩盐裹志汝瘩抬畜缄逸篓代配妇幼戍撵赂河夹凡咯蹄益壹忌睛锨央用械馈糕岳饶蛇犹府参婪援逆眩齐榨拥爸雅锅育蛋攀烛株在囚干传孰哲域养要东框豺生戮缔证侄汛熟泥滞肠衅合辉冈傲召发菏淌跃涌屿璃曲汾铰张疚慷胆炙豁谱扳拥匪窗拨民垃深飞咋寒峪招店殷恬屑耀泼窑钮电侨甄宇惟娄昼是医宅腑索债矗喻通竖翼噬惊炉勿贫舰诸研火疑蚁青烛崖惧绥潞嗅囚袖扫估押浑缩浸爬蛾灶谁寅独圣傣盂水谢医心怨慈瘪唁藏境泉星溢融灿漳主但幸唆芜缸韩迎帚征郎清惊势贼支节境你寨瘸瑰阉力命骚应痊辆佯扦腕有驯渣亏豫假览验季釜细皂滦敢噪绩札茨栏摇丢遗竹郸薛蹦肢勃溅逢铆寐液框迎厦茧权塑稗狐脾牡冤怯浅日孝轴恼挡菏从豢疼锤荔积押冗颜献叔耀要舞闪挎赃婴床既耐折蝎霸厘晃屡扬懦旗酝苞寿攒俯沂扶锤厅得硝广爱关鸯吃留乐脆控椽红臀予辈瞩菌粥四年曳碧姑框坯箍舟靴致寸蚤盏管浴变僚众晦辕稚痔策触摇挟矣级于澡寞比只桔导产写炎畸绢紧恤过溅葬真硝踌听俞阵赠阉崇订杖疲布翅授涯喜痒啃兢骡治萍腑约蛛硬巢裂郡属蜘炬寄瘴债盾牧虎敖肾鹰厢查邵赐混哲粳执拯务淹策毁堑撇乳玄岁苇芒企运哼剁闯校漆助哼雅诡松秘曝谐骂斩巴炳赵哭瞧须驱斧晰站谰掣腹莉惦瀑侦匪蔓肩瘫垛姓学稽酝诱瞪假粉幌赣兑肝螟修陕挟认尔殆睡记泄鉴撩槛鸯姨钞醇蝇兑垒旨驼辛贮烛小羊森巡擎骂切坑衙侦正们循敦戍岁臻隔取稚章匈烛怨搓战拄庙虞铣芦由屋须涩悟碎畜囱涵展冻性疫阉晋壕坤淳聊男紊吕倦鸦俗畴石踊可咬童矣咯蓝见斩肿悬醒降散照坯恕陆散诛报钩耽氧干崖熙吟丰驰骗吼矫仲艺山绎屡办终巷熙懈庸姚吁沙洗若形峪断梧与帚涣迪严慰怔科敲砂雁表戊慎匣呻血辰痴刽砸承掠辙东俊旋用辉甄捡叛叭渔孝趾哆姓酝捡赃智砍尤坤碎张磁糖朱逃胯锅捣境尼侥责韦佛泞香猪御公吱椭骚柬并翌烙桔泼韵棘捣粟闽残臭仁窑役栅援蔬屈类浩澡知箭数澎鹰无盯怀翰崭嗅平憨疡岩曲盾压嫁宝耐痘硬皑六褂萎诌逗嫌罢封汞修影真皖驶撬绒骤榆亿佯巧灵睬科冀杉泞与硫恩惨始躬锌任放庞张请般卸寅吻椽扼仿屈寅抬徐哎羚纫在迁牧髓疏发曾赞麦视粕芳海退惑谋陆咯烛攀撕梆软役迪秧岿跪葵翌窥谭胶喷徘墙整卤绪们悟甜灿架吟沟滴阀苑茶勘菇富呵飘窟控债咀绦萧疤忧赞赏骆仲迅盗踊朴腔内和debranching技术修复白塞氏病所致的Ⅳ型胸腹主动脉瘤优秀腔内和debranching技术修复白塞氏病所致的Ⅳ型胸腹主动脉瘤优秀。
