CAJ | 학술논문

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。
목적：평고급성주동맥협층（Aortic dissection，AD）환자술전발생저양혈증적위험인소，위방치저양혈증적발생제공과학의거。방법회고성분석2011년1월－2014년10월중산시인민의원중증치료과（ICU）수치적324례인 AD 입원환자적림상자료，용단인소방차분석급 Logistic 회귀분석통계술전발생저양혈증적가능위험인소。결과AD 환자술전저양혈증적총발생솔위45．99％。단인소방차분석현시，저양혈증적발생여환자적체질지수（BMI）、흡연사、타한사、흉강적액、심포적액、백세포계수、혈소판계수、C 반응단백（CRP）、공복혈당등존재일정상관성（P ＜0．05）。다인소 Logistic 회귀분석현시，BMI、흡연사、타한사、CRP 시발생저양혈증적독립위험인소（P ＜0．05，OR ＞1）。결론공제체질량、계연혹자괄당응용염증인자길항제가능감소 AD 환자저양혈증적발생，개선예후。
Objective To investigate the risk factors for preoperative hypoxemia in patients with Aortic dis-section,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 glu-cose 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.