75例Stanford A型主动脉夹层死亡危险因素临床分析  

The experience of death risk factor of 75 cases with Stanford type A aortic dissection

作　　者：王喜明[1] 赵菊 张艳霞[1] 余海彬[1] 高成山[1] 王宏山[1] 赵根尚[1] 法宪恩[1] 

机构地区：[1]郑州大学第二附属医院心血管外科,郑州450014 [2]空军郑州东郊干休所卫生所,郑州450003

出　　处：《河南外科学杂志》2017年第6期1-3,共3页Henan Journal of Surgery

基　　金：基金项目:河南省卫生科技创新型人才工程(201003040)

摘　　要：目的了解Stanford A型主动脉夹层发生和术后死亡的相关危险因素。方法回顾性分析郑州大学第二附属医院2015-01—2016-10间收治的75例Stanford A型主动脉夹层患者的临床资料。结果 (1)62.6%的患者患有高血压病。致病危险因素吸烟、饮酒仅次于高血压,所占比例分别为57.3%、46.7%。(2)主动脉阻断时间为(126.27±29.8)min,麻醉时间为(9.46±1.5)h,气管插管时间、ICU时间、住院时间分别为(113.89±168.23)h、(8.65±8.09)d、(27.48±14.93)d。(3)术后死亡7例(9.3%):4例死于多器官功能衰竭,2例死于严重肺部感染,1例死于脑卒中。结论高血压、吸烟、饮酒是A型主动脉夹层最常见的危险因素。多器官功能衰竭、肺部感染是患者术后死亡的主要原因。控制以上危险因素,可降低A型主动脉夹层的发病率和病死率。Objective To learn about the risk factors of Stanford type A aortic dissection,explore the related influence factors of mortality postoperatively in patients with type A aortic dissection. Methods A retrospective analysis of 75 patients with Stanford type A aortic dissection between January 2015 and October 2016 in cardiac surgery of the second affiliated hospital of Zhengzhou university,including gender,age,medical history and other general data,surgery and ICU date. Included the patients surgical treatment. Measurement data using mean ±standard deviation. Results ①Hypertension is the main risk factors of patients with type A dissection,62 6% of type A dissection patientswho suffer from high blood pressure disease;Smoking,drinking alcohol after high blood pressure,proportion of 57 3%,46 7% respectively;②75 patients with aorta blocking time is （ 126 27 ± 29 8）min,anesthesia time is （ 9 46 ± 1 5）h,ICU endotracheal intubation time,ICUtime,length of hospital stay,respectively （ 113 89 ± 168 23） h, （ 8 65 ± 8 09） d, （ 27 48 ± 14 93）d; ③the postoperative surgical interventiontreatment,with 7 deaths in 75 patients,mortality was 9 3%,including 4 cases died of multiple organ failure, 2 cases died of severe pulmonaryinfection,1 case died of stroke. Conclusion Hypertension,smoking,drinking alcohol is the main risk factor for type A dissection,Multipleorgan failure and pulmonary infection is two major causes of mortality postoperatively in patients with type A dissection,controlling the risk factor of above is the key to reduce the postoperative mortality of type A dissection.

关 键 词：STANFORD A型主动脉夹层 危险因素 手术干预 预后 

分 类 号：R543.1[医药卫生—心血管疾病]