中华急诊医学杂志
中華急診醫學雜誌
중화급진의학잡지
CHINESE JOURNAL OF EMERGENCY MEDICINE
2010年
11期
1151-1155
,共5页
沈洪%魏来%姚晨玲%陶振钢%奚百顺%栾骁%施东伟%孙湛%童朝阳%王春生
瀋洪%魏來%姚晨玲%陶振鋼%奚百順%欒驍%施東偉%孫湛%童朝暘%王春生
침홍%위래%요신령%도진강%해백순%란효%시동위%손담%동조양%왕춘생
急性%Stanford%A%主动脉夹层%死亡%危险因素%手术
急性%Stanford%A%主動脈夾層%死亡%危險因素%手術
급성%Stanford%A%주동맥협층%사망%위험인소%수술
Acute%Stanford A type%Aortic dissection%Death%Risk factors%Operation
目的 分析探讨急性Stanford A型主动脉夹层患者手术后死亡相关危险因素.方法 回顾性分析2003年1月至2008年6月复旦大学附属中山医院心外科接受手术治疗的急性Stanford A型主动脉夹层患者共185例,其中男性144例(77.8%),女性41例(22.2%);年龄(49.46±11.04)岁.对该组患者术后转归进行单因素和多因素Logistic回归分析.结果 术后30 d内总死亡率9.1%,单因素分析或多因素Logistic回归分析结果:术前神经系统表现阳性(单因素OR=5.084,CI=1.792～14.426,P=0.002;多因素OR=5.538,CI=1.834～16.721,P=0.002),低血压(单因素OR=6.986,CI=1.510～32.323,P=0.013;多因素OR=1.998,CI=0.315～12.679,P=0.463),肾功能不全(单因素OR=3.594,CI=1.237～10.438,P=0.019;多因素OR=3.254,CI=1.034～10.242,P=0.044).结论 术前神经系统表现阳性、肾功能不全是急性Stanford A型主动脉夹层患者手术后死亡的独立危险因素.
目的 分析探討急性Stanford A型主動脈夾層患者手術後死亡相關危險因素.方法 迴顧性分析2003年1月至2008年6月複旦大學附屬中山醫院心外科接受手術治療的急性Stanford A型主動脈夾層患者共185例,其中男性144例(77.8%),女性41例(22.2%);年齡(49.46±11.04)歲.對該組患者術後轉歸進行單因素和多因素Logistic迴歸分析.結果 術後30 d內總死亡率9.1%,單因素分析或多因素Logistic迴歸分析結果:術前神經繫統錶現暘性(單因素OR=5.084,CI=1.792～14.426,P=0.002;多因素OR=5.538,CI=1.834～16.721,P=0.002),低血壓(單因素OR=6.986,CI=1.510～32.323,P=0.013;多因素OR=1.998,CI=0.315～12.679,P=0.463),腎功能不全(單因素OR=3.594,CI=1.237～10.438,P=0.019;多因素OR=3.254,CI=1.034～10.242,P=0.044).結論 術前神經繫統錶現暘性、腎功能不全是急性Stanford A型主動脈夾層患者手術後死亡的獨立危險因素.
목적 분석탐토급성Stanford A형주동맥협층환자수술후사망상관위험인소.방법 회고성분석2003년1월지2008년6월복단대학부속중산의원심외과접수수술치료적급성Stanford A형주동맥협층환자공185례,기중남성144례(77.8%),녀성41례(22.2%);년령(49.46±11.04)세.대해조환자술후전귀진행단인소화다인소Logistic회귀분석.결과 술후30 d내총사망솔9.1%,단인소분석혹다인소Logistic회귀분석결과:술전신경계통표현양성(단인소OR=5.084,CI=1.792～14.426,P=0.002;다인소OR=5.538,CI=1.834～16.721,P=0.002),저혈압(단인소OR=6.986,CI=1.510～32.323,P=0.013;다인소OR=1.998,CI=0.315～12.679,P=0.463),신공능불전(단인소OR=3.594,CI=1.237～10.438,P=0.019;다인소OR=3.254,CI=1.034～10.242,P=0.044).결론 술전신경계통표현양성、신공능불전시급성Stanford A형주동맥협층환자수술후사망적독립위험인소.
Objective To assess the risk factors of the in-hospital mortality of acute type A aortic dissection after operation. Method From January 2003 to June 2008,185 patients, 144 males and 41 females, with acute type A aortic dissection operated on were enrolled. The average age of patients was (49.46 ± 11.04 ) years old.The patients' demographics, history, clinical features, and some laboratory examinations were reviewed. Univariate and multivariate analysis followed by logistic regression analysis were carried out to identify the predictors of inhospital mortality. Results The in-hospital mortality rate was 9.1%. The results of univariate and multivariate analyses as follows: pre-operation positive neurological symptom (Univariate OR = 5.084,95%CI:1.792 -14.426, P = 0.002; Multivariate OR = 5.538,95%CI: 1.834 - 16.721, P = 0.002, respectively), hypotension (Univariate OR = 6.986,95%CI:1.510- 32.323,P =0.013; multivariate OR = 1.998,95%CI:0.315-12.679,P = 0.463, respectively) and renal failure (Univariate OR = 3.594,95%CI:1.237 - 10.438,P =0.019; Multivariate OR = 3.254,95%CI:1.034- 10.242, P= 0.044, respectively). Conclusions There are two predictors, pre-operation positive neurological symptom and renal failure, of pre-hospital mortality found in current analyses. Our results may improve the regimen made by cardiac surgeons and emergency doctors so as to help patients and their relatives to make correct decision.
