急性Stanford A型主动脉夹层并发心脏压塞术后患者死亡风险因素分析  

Risk factors of mortality in patients with Acute type A aortic dissection and concomitant cardiac tamponade undergoing surgery

作　　者：李峰[1] 张瑞成[1] 乔博 王珂[2] 李晓召[3] Li Feng;Zhang Ruicheng;Qiao Bo;Wang Ke;Li Xiaozhao(Department of Cardiovascular surgery.Henan Provincial Chest Hospital(The Affiliated Chest Hospital of Zhengzhou University),Zhengzhou 450000,China;Department of infection prevention and control.Henan Provincial Chest Hospital(The Affiliated Chest Hospital of Zhengzhou University),Zhengzhou 450000,China;Comprehensive intensive care units.Henan Provincial Chest Hospital(The Affiliated Chest Hospital of Zhengzhou University),Zhengzhou 450000,China)

机构地区：[1]河南省胸科医院(郑州大学附属胸科医院)心血管外科,郑州450000 [2]河南省胸科医院(郑州大学附属胸科医院)感染防控科,郑州450000 [3]河南省胸科医院(郑州大学附属胸科医院)综合重症监护病房二病区,郑州450000

出　　处：《河南外科学杂志》2023年第3期1-3,共3页Henan Journal of Surgery

基　　金：河南省医学科技攻关计划(联合共建)项目(LHGJ20190741)。

摘　　要：目的分析急性Stanford A型主动脉夹层(ATAAD)并发心脏压塞术后患者死亡风险因素。方法选取2015-01-2022-12河南省胸科医院心血管外科收治的73例ATAAD并发心脏压塞行主动脉外科手术的患者,按生存结局将患者分为死亡组(18例)和对照组(55例)。对纳入患者的临床资料进行统计学分析。结果单因素分析结果显示,年龄、术前休克状态、D-二聚体,以及手术时间和早期死亡显著相关(P<0.05)。多因素Logistic回归分析结果显示,术前休克状态、D-二聚体、发病至入院时间和手术时间是ATAAD合并心脏压塞术后死亡的独立风险因素(P<0.05)。结论对于ATAAD合并心脏压塞术后患者,术前休克状态、D-二聚体、发病至入院时间和手术时间与死亡独立相关。Objective To explore the risk factors of early death in patients with acute type A aortic dissection(ATAAD)and concomitant cardiac tamponade undergoing surgery.Methods We reviewed 73 patients with ATAAD and concomitant cardiac tamponade who underwent surgical repair at Henan Provincial Chest Hospital from January 2015 to December 2022.The patients were divided into early mortality group(18 patients)and control group(55 patients),baseline characteristics and clinical variables were analyzed.Results The univariate analysis shows age,shock status,D-dimer level,and operation time were associated with early mortality(P<0.05).Further multivariable analysis shows onset-admission time,shock status,D-dimer level,and operation time were independent predictors of early mortality.(P<0.05).Conclusion Onset-admission time,shock status,D-dimer level,and operation time were independently associated with early mortality in patients with ATAAD and concomitant cardiac tamponade undergoing surgical repair.

关 键 词：急性Stanford A型主动脉夹层 术后病死率 风险因素 心脏压塞 

分 类 号：R543.16[医药卫生—心血管疾病]