Stanford A型主动脉夹层术后低氧血症的围手术期危险因素分析
Chinese Journal of Postgraduates of Medicine(2018)
Abstract
目的 探讨Stanford A型主动脉夹层术后低氧血症的围手术期危险因素.方法 回顾性分析77例Stanford A型主动脉夹层手术患者的临床资料,其中术后发生低氧血症40例(低氧血症组),术后未发生低氧血症37例(非低氧血症组).比较两组术前、术中、术后的临床资料,并进行多因素Logistic回归分析.结果 Stanford A型主动脉夹层患者术后低氧血症发生率为51.9%(40/77).多因素Logistic回归分析结果显示,年龄(OR=1.088,95% CI 1.018~1.164,P=0.013)、体质量指数≥25 kg/m(2OR=6.495,95% CI 1.327~31.789,P=0.021)、心包积液(OR=6.384,95% CI 1.426~28.576,P = 0.015)、白细胞计数(OR = 1.289,95% CI 1.033~1.609,P =0.024)、使用重组人凝血因子Ⅶa(OR=23.757,95% CI 2.849~198.085,P=0.003)是Stanford A型主动脉夹层患者术后发生低氧血症的独立危险因素.结论 Stanford A型主动脉夹层患者术后发生低氧血症与围手术期存在的全身性炎性反应有关,尤其是肥胖患者,术前和术中应积极给予抗炎处理.控制出血,尽可能减少重组人凝血因子Ⅶa的使用,可减少术后低氧血症的发生.
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Key words
Aortic Dissection,Type B Aortic Dissection,Stroke After Cardiac Surgery
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