Bentall手术治疗主动脉根部疾病的效果及影响患者围术期死亡的危险因素分析

Analysis of effect of Bentall operation on aortic root disease and risk factors affecting perioperative death of patients

目的探讨Bentall手术治疗主动脉根部疾病的效果及影响围术期患者死亡的危险因素。方法回顾性分析在我院行Bentall手术的87例患者的临床资料,根据有无死亡将其分为死亡组(n=7)和未死亡组(n=80)。分析影响Bentall手术患者围术期死亡的危险因素,并比较未死亡组术前及术后不同时间的LVEDD、LVEF。结果围手术期死亡7例(8.05%),出现并发症17例(19.54%),成功随访1年的76例(95.00%)。单因素分析结果显示,两组的年龄、合并其他手术、体外循环时间有显著差异(P<0.05)。多因素Logistic回归分析结果显示,合并其他手术和体外循环时间是影响Bentall手术患者围术期死亡的独立危险因素(P<0.05)。患者术后每一个随访节点的LVEDD和LVEF同前一次比较,差异显著(P<0.05)。结论Bentall手术治疗主动脉根部疾病的近、中期疗效满意,合并其他手术和体外循环时间是影响Bentall手术患者围术期死亡的独立危险因素。

Objective To explore the effect of Bentall operation on aortic root disease and the risk factors affecting perioperative death of patients.Methods The clinical data of 87 patients who underwent Bentall operation in our hospital were analyzed retrospectively,and the patients were divided into death group(n=7)and non-death group(n=80)according to whether they died or not.The risk factors of perioperative death of patients in Bentall operation were analyzed,and LVEDD and LVEF in the non-death group were compared before operation and at different time after operation.Results Seven cases(8.05%)died during the perioperative period,17 cases(19.54%)had complications,and 76 cases(95.00%)were successfully followed up for one year.Univariate analysis result showed that there were significant differences in age,combined with other operations and cardiopulmonary bypass time between the two groups(P<0.05).Multivariate Logistic regression analysis result showed that combined with other operations and cardiopulmonary bypass time were independent risk factor for perioperative death in Bentall operation patients(P<0.05).The LVEDD and LVEF at each follow-up node were significantly different from the previous time point(P<0.05).Conclusion The short and medium-term efficacy of Bentall operation on aortic root disease is satisfactory.Combined with other operations and cardiopulmonary bypass time are independent risk factor affecting the perioperative death of Bentall operation patients.