| 166 | 7 | 7 |
| 下载次数 | 被引频次 | 阅读次数 |
目的评估急性主动脉夹层(Aortic dissection,AD)患者术前发生低氧血症的危险因素,为防治低氧血症的发生提供科学依据。方法回顾性分析2011年1月-2014年10月中山市人民医院重症治疗科(ICU)收治的324例因AD入院患者的临床资料,用单因素方差分析及Logistic回归分析统计术前发生低氧血症的可能危险因素。结果 AD患者术前低氧血症的总发生率为45.99%。单因素方差分析显示,低氧血症的发生与患者的体质指数(BMI)、吸烟史、打鼾史、胸腔积液、心包积液、白细胞计数、血小板计数、C反应蛋白(CRP)、空腹血糖等存在一定相关性(P<0.05)。多因素Logistic回归分析显示,BMI、吸烟史、打鼾史、CRP是发生低氧血症的独立危险因素(P<0.05,OR>1)。结论控制体质量、戒烟或者适当应用炎症因子拮抗剂可能减少AD患者低氧血症的发生,改善预后。
Abstract：Objective To investigate the risk factors for preoperative hypoxemia in patients with Aortic dissection,to search for the prevention of preoperative hypoxemia.Methods A retrospective analysis of 324 patients with Aortic dissection was performed from January 2011 to October 2014.Univariate analysis and multivariate logistic regression were performed between hypoxemia group and nonhypoxemia group.Results In these patients,45.99% had hypoxemia before operation.Univariate analysis showed that BMI,smoking,snore,pleural effusion,pericardial effusion,WBC,PLT,C reactive protein(CRP),blood glucose were correlated with preoperative hypoxemia(P <0.05).Multivariate logistic regression showed that BMI,smoking,snore,CRP were the main risk factors for preoperative hypoxemia(P <0.05,OR >1).Conclusion In order to prevent the occurrence of preoperative hypoxemia in AD patients,the measures such as preoperative hypoxemia,stop smoking,application of antagon for inflammatory factor before the surgery are necessary.
[1]Divchev D,Najjar T,Tillwich F,et al.Predicting long-term outcomes of acute aortic dissection:a focus on gender[J].Expert Rev Cardiovasc Ther,2015,13(3):325-331.
[2]Fattori R,Cao P,De Rango P,et al.Interdisciplinary expert consensus document on management of type B aortic dissection[J].J Am Coll Cardiol,2013,61(1):1661-1678.
[3]Grommes J,Greiner A,Bendermacher B,et al.Risk factors for mortality and failure of conservative treatment after aortic type B dissection[J].J Thorac Cardiovasc Surg,2014,148(1):2155-2160.
[4]刘曌宇,柴博兰,邹远林,等.482例主动脉夹层患者死亡因素的Logistic回归分析[J].华中科技大学学报:医学版,2014,43(6):697-700.
[5]Sarkola T,Manlhiot C,Slorach C,et al.Evolution of the arterial structure and function from infancy to adolescence is related to anthropometric and blood pressure changes[J].Arterioscler Thromb Vasc Biol,2012,32(2):2516-2524.
[6]Covella M,Milan A,Totaro S,et al.Echocardiographic aortic root dilatation in hypertensive patients:a systematic review and meta-analysis[J].J Hypertens,2014,32(10):1928-1935.
[7]沈洪,姚晨玲,陶振钢,等.361例主动脉夹层的临床分析[J].中国急救医学,2009,29(6):499-502.
[8]Clough RE,Patel AS,Lyons OT,et al.Pathology specific early outcome after thoracic endovascular aortic repair[J].Eur J Vasc Endovasc Surg,2014,48(3):268-275.
[9]刘皇军,金立军,刘雪银,等.急性主动脉夹层并发心包积液患者的临床特征及住院期间转归分析[J].广东医学,2012,33(6):846-847.
[10]Trimarchi S,Tolenaar JL,Tsai TT,et al.Influence of clinical presentation on the outcome of acute B aortic dissection:evidences from IRAD[J].J Cardiovasc Surg,2012,53(2):161-168.
[11]Thorsgard ME,Morrissette GJ,Sun B,et al.Impact of intraoperative transesophageal echocardiography on acute type-A aortic dissection[J].J Cardiothorac Vasc Anesth,2014,28(5):1203-1207.
[12]Paparella D,Rotunno C,Guida P,et al.Hemostasis alterations in patients with acute aortic dissection[J].Ann Thorac Surg,2011,91(5):1364-1369.
[13]Howard LS,Santhirapala V,Murphy K,et al.Cardiopulmonary exercise testing demonstrates maintenance of exercise capacity in patients with hypoxemia and pulmonary arteriovenous malformations[J].Chest,2014,146(3):709-718.
[14]Keropian B,Murphy NC,Yong M.Treating obstructive sleep apnea.A manifest destiny for 21st century dentists[J].Dent Today,2014,33(9):138,140-142.
基本信息:
中图分类号:R543.1
引用信息:
[1]杨婷,马磊,林静梨,等.急性主动脉夹层患者术前发生低氧血症的危险因素分析[J].新疆医科大学学报,2015,38(09):1117-1120.
基金信息:
广东省科技计划项目(2012B031800094)
2015-03-05
2015
2015-07-06
2015
1
2015-09-15
2015-09-15