深低温停循环下主动脉弓手术后患者预后分析

The prognosis of patients after aortic arch surgery requiring deep hypothermic circulatory arrest

目的:探讨在深低温停循环(DHCA)状态下,主动脉弓手术后患者预后危险因素。方法:回顾性分析我院心脏外科2006年1月至2007年12月期间主动脉弓手术后患者的临床资料。结果:58例主动脉弓手术,术后死亡6例,病死率10.34%。单因素分析发现转机时间、术后血肌酐水平、术后神经功能障碍及需要连续肾脏替代治疗是影响预后的危险因素。结论:围手术期急性肾损伤和中枢神经系统损伤是手术死亡的独立危险因素。

Objective： To analyze the prognosis of patients receiving aortic arch surgery requiring deep hypothermic circulatory arrest （DHCA）. Method：The clinical data of patients after aortic arch surgery-DHCA in our hospital from January 2006 to December 2007 were studied retrospectively. Result： There were 58 patients after aortic arch surgery-DHCA during the study period. The overall mortality rate was 10.34%, the risk factors of prognosis after aortic arch surgery -DHCA were duration of cardiopulmonary bypass, duration of aortic cross-clamping, postperative serum creatinine, postoperative neurological dysfunction and continuous renal replacement therapy （CRRT）. Conclusion：The main organs dysfunction after aortic arch surgery -DHCA was the predictor of poor prognosis, the risk factors merit further focused research to the perioperative organ protection.