胸腹降主动脉置换术后发生脊髓损伤危险因素分析  

Analysis of Risk Factors for Spinal Cord Injury after Descending Thoracic and Abdominal Aortic Aneurysm Repair

作　　者：王苏德娜 王春蓉[1] 高宇晨 田宇 刘佳[1] 王剑辉[1] 王越夫[1] WANG Sude-na;WANG Chun-rong;GAO Yu-chen;TIAN Yu;LIU Jia;WANG Jian-hui;WANG Yue-fu(Department of Anesthesiology,Fuwai Hospital,National Center for Cardiovascular Diseases,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing,100037,China)

机构地区：[1]中国医学科学院北京协和医学院国家心血管病中心阜外医院麻醉中心,北京市100037

出　　处：《中国分子心脏病学杂志》2021年第1期3715-3718,共4页Molecular Cardiology of China

摘　　要：目的研究胸腹降主动脉置换术后发生脊髓损伤的围术期风险因素。方法收集2013年3月至2018年9月130例行胸腹降主动脉置换术患者的临床资料。对所有变量进行单因素Logistic回归,将P<0.2的变量及临床中认为可能影响术后脊髓缺血的因素纳入多因素Logistic回归模型中进行逐步剔除法建立方程。结果体质量指数(BMI)≥30 kg/m^(2)(B:1.692,OR:5.428,95%CI:1.241~23.744,P=0.025)以及胸主动脉近端阻断时间延长(B:0.020,OR:1.02,95%CI:1.000~1.040,P=0.045)与胸腹降主动脉置换术后发生脊髓损伤有显著相关性。结论BMI≥30 kg/m^(2)及胸主动脉近端阻断时间延长是胸腹降主动脉置换术后脊髓损伤的独立危险因素。Objective To investigate perioperative risk factors associated with spinal cord injury(SCI)after open descending thoracic and abdominal aortic aneurysm repair.Methods Clinical data of 130 patients undergoing descending thoracic and abdominal aortic aneurysm repair from March 2013 to September 2018 were collected.Variables with P<0.2 and considered factors that may affect postoperative spinal cord ischemia in the clinical practice were incorporated into the multivariate Logistic regression model.Results Body mass index(BMI)≥30 kg/m^(2)(B:1.692,OR:5.428,95%CI:1.241~23.744,P=0.025)and thoracic aortic cross clamp time(B:0.020,OR:1.02,95%CI:1.000~1.040,P=0.045)were significantly associated with spinal cord injury after descending thoracic and abdominal aortic aneurysm repair.Conclusions BMI≥30 kg/m^(2)and prolonged thoracic aortic cross clamp time were independent risk factors for spinal cord injury after descending thoracic and abdominal aortic aneurysm repair.

关 键 词：脊髓损伤 胸腹主动脉置换术 

分 类 号：R654.3[医药卫生—外科学] R651.2[医药卫生—临床医学]