A型主动脉夹层术后神经系统并发症的相关危险因素分析-东南大学学报医学版

A型主动脉夹层术后神经系统并发症的相关危险因素分析

单位：郑州大学第二附属医院心血管外科, 河南郑州 450014

分类号：R543.16

出版年·卷·期（页码）：2017·36·第三期（361-364）

摘要：

目的：探讨A型主动脉夹层（TAAD）患者术后神经系统并发症的相关危险因素。方法：收集我院心血管外科行手术治疗的66例TAAD患者的相关资料，按照术后有无神经系统并发症发生分成两组，进行单因素、多因素Logistic回归分析。结果：TAAD术后神经系统并发症发生率为39.4%（26/66），其中短暂性神经功能损害占33.3%（22/66），永久性神经功能损害占6.1%（4/66）。多因素Logistic回归分析结果提示体外循环时间和ICU时间是TAAD术后神经系统并发症的危险因素。结论：体外循环时间和ICU时间是TAAD术后神经系统并发症的独立危险因素。

Objective:To analyze the risk factors of nervous system diseases in patients after type A aortic dissection surgery. Methods:The data of 66 patients after type A aortic dissection surgery were collected, divided into two groups according to the presence or absence of nervous system diseases and analyzed by the single factor and multiple factors logistic regression analysis. Results:The incidence of nervous system diseases in patients after type A aortic dissection surgery was 39.4%(26/66), of which transient neurological deficit was 33.3%(22/66)and permanent neurological deficit was 6.1%(4/66). Multiple factors logistic regression analysis showed that cardiopulmonary bypass time and ICU stay time were the risk factors of nervous system diseases in patients after type A aortic dissection surgery. Conclusion:Cardiopulmonary bypass time and ICU stay time are the independent risk factors of nervous system diseases in patients after type A aortic dissection surgery.

参考文献：

[1] 吴锦鸿,许国根,章浩,等.主动脉夹层动脉瘤患者不同Stanford分型的临床特征分析及意义[J].中华危重症医学杂志:电子版,2010(5):318-321.
[2] ZHENG Z,YE Z,HUANG Y,et al.A case report of acute myocardial infarction concomitant with Standford type B aortic dissection[J].J Cardiovasc Dis Res,2013,4(4):251-253.
[3] HOWARD D P,BANERJEE A,FAIRHEAD J F,et al.Population-based study of incidence and outcome of acute aortic dissection and premorbid risk factor control:10-year results from the Oxford Vascular Study[J].Circulation,2013,127(20):2031-2037.
[4] SUN L,QI R,ZHU J,et al.Repair of acute type A dissection:our experiences and results[J].Ann Thorac Surg,2011,91(4):1147-1152.
[5] HALDENWANG P L,WAHLERS T,HIMMELS A,et al.Evaluation of risk factors for transient neurological dysfunction and adverse outcome after repair of acute type A aortic dissection in 122 consecutive patients[J].Eur J Cardiothorac Surg,2012,42(5):e115-e120.
[6] NAITO K,NISHIDA H,TAKANASHI S.Permanent neurological deficit in surgical repair for acute type A aortic dissection[J].Kyobu Geka,2016,69(4):299-303.
[7] CONZELMANN L O,HOFFMANN I,BLETTNER M,et al.Analysis of risk factors for neurological dysfunction in patients with acute aortic dissection type A:data from the German Registry for Acute Aortic Dissection type A(GERAADA)[J].Eur J Cardiothorac Surg,2012,42(3):557-565.
[8] 尚蔚,刘楠,闫晓蕾,等.TAAD手术后早期并发症分析[J].心肺血管病杂志,2011(3):183-186.
[9] BAEHNER T,BOEHM O,PROBST C,et al.Cardiopulmonary bypass in cardiac surgery[J].Anaesthesist,2012,61(10):846-856.
[10] 郑军,田川.心脏血管术后脑损伤——概念与机理(第一部分)[J].中国分子心脏病学杂志,2005(6):763-769.
[11] KRUGER T,WEIGANG E,HOFFMANN I,et al.Cerebral protection during surgery for acute aortic dissection type A:results of the german registry for acute aortic dissection type A(GERAADA)[J].Circulation,2011,124(4):434-443.
[12] WHTILOCK E L,VANNUCCI A,AVIDAN M S.Postoperative delirium[J].Minerva Anestesiol,2011,77(4):448-456.
[13] LAT I,MCMILLIAN W,TAYLOR S,et al.The impact of delirium on clinical outcomes in mechanically ventilated surgical and trauma patients[J].Crit Care Med,2009,37(6):1898-1905.

服务与反馈：

【文章下载】【发表评论】【查看评论】【加入收藏】

提示：您还未登录，请登录！点此登录