Stanford A型主动脉夹层患者术后延迟拔管的危险因素分析及护理  

A Study of Risk Factors and Nursing of Postoperative Delayed Tracheal Extubation for Patients with Stanford Type A Aortic Dissection

作　　者：苏云艳[1] 范阜东[1] 熊剑秋[1] 李丽[1] 

机构地区：[1]南京大学医学院附属鼓楼医院心胸外科,江苏南京210008

出　　处：《解放军护理杂志》2015年第23期61-63,共3页Nursing Journal of Chinese People's Liberation Army

摘　　要：目的分析Stanford A型主动脉夹层患者术后气管插管延迟拔除的危险因素,促进围术期康复。方法回顾性分析2009年1月至2014年12月于南京大学医学院附属鼓楼医院心胸外科行手术治疗的146例Stanford A型主动脉夹层患者资料。根据术后气管插管是否延迟拔除,将患者分为延迟拔管组(96例)及非延迟拔管组(50例),比较两组患者的临床资料,分析Stanford A型主动脉夹层术后气管插管延迟拔除的危险因素。结果 Stanford A型主动脉夹层患者术后气管插管延迟拔除发生率为65.7%(96/146)。96例延迟拔管患者中2013年以前收治的有62例,占64.5%(62/96);2013年以后收治的有34例,占35.4%(34/96)。通过统计学分析发现气管插管拔管延迟组年龄高于非延迟组年龄,心肌阻断时间长于非延迟拔管组(均P<0.05),延迟拔管组患者总输血量明显增加(P<0.001)。结论气管插管延迟拔除影响患者围术期康复,因此,对于Stanford A型主动脉夹层行外科治疗的患者,尤其是高龄患者,尽量减少围术期血制品的输入,同时护理人员应加强对延迟拔管患者的护理,提高围术期安全。Objective To analyze the risk factors of postoperative delayed tracheal extubation for patients with Stanford type A aortic dissection,in order to promote perioperative recovery.Methods Clinical data of 146 cases were analyzed retrospectively.The patients were divided into delayed extubation group （n = 96） and normal extubation group （n =50）.The clinical data was compared and the risk factors of postoperative delayed tracheal extubation for patients with Stanford type A aortic dissection were analyzed.Results The incidence rate of postoperative delayed tracheal extubation for patients with Stanford type A aortic dissection was 65.7% （96/146）.Among 96 cases,there were 62 cases admitted in hospital before 2013, which accounted for 64.5% （62/96）,and 34 cases were admitted after 2013, which accounted for 35.4% （34/96）. Multivariable analysis indicated that the age of delayed extubation group was older than the normal extubation group,and the circulatory arrest time was longer than the normal extubation group （all P〈0.05） ,also with more blood transfusion in delayed extubation group（P〈0.001）.Conclusion The delayed tracheal extubation can affect the perioperative recovery. Therefore, for patients with Stanford type A aortic dissection,especially for those who with older age, there is need to reduce the transfusion, and the nurses should strengthen the nursing for patients with delayed tracheal extubation,thus to improve the perioperative safety.

关 键 词：STANFORDA型主动脉夹层 延迟拔管 危险因素 护理 

分 类 号：R543.1[医药卫生—心血管疾病]