急性A型主动脉夹层术前并发严重低氧血症相关因素的回顾性分析  

Association of hypoxaemia in patient with acute stanford type A aortic dissection

作　　者：杨彦伟 郭子健 金沐 卢家凯[3] 程卫平[3] YANG Yanwei;GUO Zijian;JIN Mu;LU Jiakai;CHENG Weiping(Department of Anaesthesiology,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院麻醉科,100050 [2]北京大学口腔医院麻醉科 [3]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所麻醉科

出　　处：《心肺血管病杂志》2019年第9期942-945,共4页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:探究急性A型主动脉夹层术前严重低氧血症的相关因素,为该并发症的早期防治提供相关依据。方法:回顾性分析于首都医科大学附属北京安贞医院2015年1月至2018年2月期间,收治的505例急性A型主动脉夹层患者,根据氧合指数是否≤200 mmHg(1 mmHg=0.133 kPa)将其分为低氧血症(+)组和低氧血症(-)组,分析两组患者围术期指标,归纳并总结术前并发低氧血症的相关危险因素。结果:急性A型主动脉夹层术前发生严重低氧血症概率为12%(62/505)。单因素分析中有统计学意义的危险因素包括BMI、手术到发病时间、心包积液、WBC计数、cTnI、活化部分凝血活酶、收缩压、PLT计数、D-Dimer、纤维蛋白原降解产物。Logistic回归分析WBC计数、收缩压为术前并发严重低氧血症的危险因素。结论:12%的患者术前存在严重低氧血症,WBC计数、收缩压为急性A型主动脉夹层术前并发低氧血症的预测因素。Objective: to explore the related factors of preoperative severe hypoxaemia before Acute Type A Aortic Dissection(AAD) and to provide relevant evidence for the early prevention and treatment of this complication. Methods: A retrospective analysis in Capital Medical University Affiliated Beijing Anzhen hospital between January 2015 and February 2018. All of these 505 patients with AAD that underwent surgery treatment were divided into hypoxaemia(+) group and hypoxaemia(-) group according to the oxygenation index, univariable and multivariable analyses were performed on the clinical data of these patients. Results: The incidence of hypoxaemia of AAD was 12%(62/505). The independent risk factors of preoperative HO were body mass index, time from surgery to onset, pericardial effusion, white blood cell count(WBC), troponin(TNI), activated partial thromboplastin(APTT), systolic blood pressure, platelet count, D-Dimeric concentration and fibrinogen degradatio n products(FDP). Multivariable binary logistic regression analysis show that White blood cell count and systolic blood pressure were risk factors for hypoxaemia retrospective. Conclusions: 12% of the patients suffered from severe hypoxaemia retrospective. White blood cell count and systolic blood pressure were independent predictors of hypoxaemia retrospective.

关 键 词：急性A型主动脉夹层 低氧血症 危险因素 

分 类 号：R54[医药卫生—心血管疾病]