急性主动脉夹层患者术前发生低氧血症的危险因素分析

Risk factors analysis of preoperative hypoxemia in patients with Aortic dissection

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。

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 324patients 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 measuressuch as preoperative hypoxemia, stop smoking, application of antagon for inflammatory factor before the surgery are necessary.