大动脉炎开放手术围手术期并发症的危险因素分析  

Analysis of risk factors of perioperative complications of open surgery for Takayasu arteritis

作　　者：刁永鹏[1] 苗雨晴 陈作观 谭树平[1] 兰勇[1] 李鹏[1] 王吉阳[1] 陈跃鑫[2] 田新平[3] 李拥军[1] DIAO Yongpeng;MIAO Yuqing;CHEN Zuoguan;TAN Shuping;LAN Yong;LI Peng;WANG Jiyang;CHEN Yuexin;TIAN Xinping;LI Vongjun(Department of Vascular Surgery,Beijing Hospital,National Center for Geriatrics,Peking Union Medical College,Beijing 100730,China;Department of Vascular Surgery,Peking Union Medical College Hospital,Beijing 100032,China;Department of Rheumatology and Immunology,Peking Union Medical College Hospital,Beijing 100032,China)

机构地区：[1]北京医院血管外科,北京协和医学院,国家老年医学中心,北京100730 [2]中国医学科学院北京协和医院血管外科,北京100032 [3]中国医学科学院北京协和医院风湿免疫科,北京100032

出　　处：《中国普通外科杂志》2019年第12期1455-1461,共7页China Journal of General Surgery

基　　金：中央高校基本科研业务基金资助项目（3332018174）;北京医院临床研究121工程基金资助项目（BJ-2018-089）

摘　　要：目的:探讨影响大动脉炎(TA)患者行开放手术治疗发生围手术期并发症的相关危险因素。方法:回顾性分析2003年1月-2018年12月136例行开放血管重建治疗的TA患者资料,采用单因素及多因素Logistic统计学方法分析影响开放手术围手术期并发症的相关危险因素。结果:136例患者共行开放手术141例次,涉及病变257处。围手术期并发症共发生36例次(25.5%),其中5例患者(3.7%)死亡。单因素分析结果显示,脑梗死病史、术前CRP升高、颈动脉受累、围手术期输血、血管受累数量、动脉阻断时间及术中出血量与围手术期并发症的发生有关(均P<0.05);多因素Logistic分析显示,脑梗死病史(OR=3.141,95%CI=1.062~9.288,P=0.039)、血管受累数量(OR=1.280,95%CI=1.016~1.612,P=0.036)和术中动脉阻断时间(OR=1.045,95%CI=1.007~1.084,P=0.019)是围手术期并发症的独立危险因素。结论:术前脑梗死病史,血管受累数量多和术中动脉阻断时间长会增加TA患者开放手术围手术期并发症的风险。Objective:To investigate the risk factors for the occurrence of perioperative complications in patients undergoing open surgery for Takayasu arteritis(TA).Methods:The data of the 136 TA patients undergoing open revascularization from January 2003 to December 2018 were retrospectively analyzed and the risk factors for perioperative complications of open surgery were determined by univariate and multivariate statistical tests.Results:In the 136 patients,open operation was performed 141 times,involving 257 lesions.Thirty-six episodes(25.5%)of perioperative complications occurred in the patients,including death in 5 patients(3.7%).The results of univariate analysis showed that the history of cerebral infarction,preoperative increased CRP level,carotid artery involvement,perioperative blood transfusion,number of involved vessels,artery occlusion time and intraoperative blood loss were associated with the occurrence of perioperative complications(all P<0.05).The results of multivariate Logistic regression analysis showed that the history of cerebral infarction(OR=3.141,95%CI=1.062–9.288,P=0.039),number of vascular involvement(OR=1.280,95%CI=1.016–1.612,P=0.036)and artery occlusion time(OR=1.045,95%CI=1.007–1.084,P=0.019)were independent risk factors for perioperative complications.tions.Conclusion:Preoperative history of cerebral infarction,multiple vascular involvement and prolonged artery occlusion will increase the risk of perioperative complications in TA patients undergoing open surgery.

关 键 词：TAKAYASU动脉炎 血管外科手术 手术中并发症 于术后并发症 危险因素 

分 类 号：R654.3[医药卫生—外科学]