Stanford A型主动脉夹层术后重度低氧血症临床分析

郝智鹏; 王咏; 朱雨; 王海龙; 刘凌超; 肖颖彬

doi:10.16016/j.1000-5404.202001031

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Stanford A型主动脉夹层术后重度低氧血症临床分析

临床医学 | 更新时间：2026-01-09

- Stanford A型主动脉夹层术后重度低氧血症临床分析
- Severe hypoxemia after Stanford A aortic dissection surgery: a clinical analysis of 162 cases
- 第三军医大学学报 2020年42卷第9期页码：929-936
- 作者机构：
  
  400037 重庆，陆军军医大学(第三军医大学)第二附属医院全军心血管外科研究所
- 作者简介：
  
  [ 肖颖彬，E-mail:xiaoyb@tmmu.edu.cn XIAO Yingbin, E-mail:xiaoyb@tmmu.edu.cn
- 基金信息：
- DOI：10.16016/j.1000-5404.202001031
  中图分类号： R619;R654.3;R845.22
- 收稿：2020-01-05，
  
  修回：2020-03-06，
  
  纸质出版：2020-05-15
- 稿件说明：
移动端阅览
郝智鹏, 王咏, 朱雨, 等. Stanford A型主动脉夹层术后重度低氧血症临床分析[J]. 第三军医大学学报, 2020,42(9):929-936.

Zhipeng HAO, Yong WANG, Yu ZHU, et al. Severe hypoxemia after Stanford A aortic dissection surgery: a clinical analysis of 162 cases[J]. Journal of Third Military Medical University, 2020, 42(9): 929-936.
郝智鹏, 王咏, 朱雨, 等. Stanford A型主动脉夹层术后重度低氧血症临床分析[J]. 第三军医大学学报, 2020,42(9):929-936. DOI： 10.16016/j.1000-5404.202001031.

Zhipeng HAO, Yong WANG, Yu ZHU, et al. Severe hypoxemia after Stanford A aortic dissection surgery: a clinical analysis of 162 cases[J]. Journal of Third Military Medical University, 2020, 42(9): 929-936. DOI： 10.16016/j.1000-5404.202001031.

摘要

目的

对Stanford A型主动脉夹层进行临床分析，探讨手术后重度低氧血症的危险因素。

方法

纳入2016年1月至2019年3月期间162例Stanford A型主动脉夹层并接受住院手术治疗的患者进行回顾性分析。患者术后72 h内氧合指数(PaO

/FiO

)≤100 mmHg为重度低氧组，PaO

/FiO

100 mmHg为非重度低氧血症组。比较两组患者围术期临床指标，并分析重度低氧血症相关危险因素。

结果

患者术后重度低氧血症发生率50.6%(82/162)，重度低氧血症患者机械通气时间、术后ICU时间和术后住院时间较非重度低氧血症组患者显著延长(

0.05)。术后早期死亡率11.7%(19/162)，重度低氧血症组17.1%(14/82)显著高于非重度低氧血症组6.1%(5/80)(

=0.032)；多因素回归分析显示，BMI

24 kg/m

，术前PaO

/FiO

≤300 mmHg和体外循环(cardiopulmonary bypass

CPB)时间

195 min为术后重度低氧血症的独立危险因素。

结论

BMI

24 kg/m

、术前PaO

/FiO

≤300 mmHg、CPB时间

195 min是Stanford A型主动脉夹层术后重度低氧血症的独立危险因素。

Abstract

Objective

To investigate the risk factors for post-operative severe hypoxemia in patients with Stanford A aortic dissection.

Methods

Clinical data of 162 patients with Stanford A aortic dissection undergoing surgical treatment in our hospital from January 2016 to March 2019 were collected and retrospectively analyzed in this study. According to their oxygenation index(PaO

/FiO

) within 72 h after operation

they were divided into severe hypoxia group (≤100 mmHg) and non-severe hypoxemia group(

100 mmHg). The perioperative clinical indexes were compared between the 2 groups

and the risk factors of severe hypoxemia were analyzed.

Results

The incidence of severe hypoxemia was 50.6%(82/162) in the cohort. The severe hypoxia group had significantly longer time of mechanical ventilation

postoperative length of ICU stay and hospital stay when compared with the non-severe hypoxia group(all

0.05). The total mortality rate was 11.7%(19/162)

with that in the severe group obviously higher than that of the other group. Multivariate regression analysis showed that BMI

24 kg/m

(

=2.604

95%

: 1.055~6.427

=0.038)

preoperative PaO

/FiO

≤300 mmHg(

=2.963

95%

: 1.283~6.841

=0.011) and cardiopulmonary bypass(CPB) time

195 min(

=1.007

95%

: 1.000~1.014

0.044) were independent risk factors for post-operative severe hypoxemia after surgery.

Conclusion

BMI

24 kg/m

preoperative PaO

/FiO

≤300 mmHg and CPB time

195 min are independent risk factors for post-operative severe hypoxemia after surgery of Stanford type A aortic dissection.

关键词

Keywords

references

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