摘要
目的分析DeBakeyⅠ型主动脉夹层术后患者发生急性呼吸功能不全（ARD）的相关危险因素，为制定预防和治疗措施提供依据。方法回顾性分析18例在深低温体外循环下应用三分支型主动脉弓腔内覆膜支架手术治疗的DeBakeyⅠ型主动脉夹层患者的临床资料，记录患者的年龄、性别、术前合并症、有无灌注不良综合征、体外循环时间和主动脉阻断时间。监测术前及术后的血气分析、胸部X线片、呼吸机参数及术中术后输血量，对术后发生ARD的相关危险因素进行单因素分析。结果围手术期无死亡病例，18例患者中，术前存在灌注不良综合征5例，8例患者术后发生ARD，其中3例于术后48．72h发生，5例于术后48h内发生。3例因机械通气时间大于7d行气管切开。相关因素分析显示，术后发生ARD与体质指数（P=0．047）、深低温停循环时间（P=0．035）有关。结论ARD是急性DeBakeyⅠ型主动脉夹层围手术期的常见并发症，充分重视危险因素并积极防治后多可纠正，预后良好。
Objective To analyze the risk factors associated with respiratory dysfunction （ARD） in patients with DeBakey type I aortic dissection after operation and provide the measures for prevention and treatment. Methods Retrospectively analyzed the clinical data of DeBakey Ⅰtype aortic dissection 18 patients under deep hypothermic cardiopulmonary bypass from September 2008 to March 2012 in the application of the three-branch type aortic arch endovascular stent. Recorded age, sex, preoperative complication, with or without perfusion badness syndrome, cardiopulmonary bypass time and aortic cross-clamping time. Monitoring preoperative and postoperative blood gas analysis, chest X-ray, ventilator parameters, intraoperative and postoperative blood transfusion. The single factor analysis of the risk factors associated with postoperative ARD was analyzed. Results No patient died in peroperative period. Five patients （27.8%） was in perfusion badness syndrome preoperative,8 patients （44.4%） was in ARD postoperative.Three patients （16.7%） occurred within 72 h and 5 patients （27.8%） occurred within 48 h. Three patients （16.7%） performed incision of tracheal for the duration of mechanical ventilation for more than 7d. Correlation factor analysis showed that BMI （P = 0.047）, circulatory arrest time （P = 0.035） had correlation with postoperative ARD. Conclusions ARD is a common complication during perioperative. It can be correctable by pay full attention to the risk factors, and the prognosis is good.
出处
《中国医师进修杂志》
2013年第5期34-37,共4页
Chinese Journal of Postgraduates of Medicine
关键词
动脉瘤
夹层
呼吸功能不全
危险因素
Aneurysm,dissecting
Respiratory insufficiency
Risk factors
