急性Stanford A型主动脉夹层术前低氧血症危险因素的Meta分析

Risk factors of preoperative hypoxemia in patients with acute Stanford type A aortic dissection surgery:a meta-analysis

目的探讨急性Stanford A型主动脉夹层(ATAAD)术前低氧血症的危险因素。方法计算机检索中国知网、万方、Pubmed等数据库在2021年4月之前公开发表的相关文献,由2名研究员筛选文献、提取数据,并进行质量评价。采用Revman 5.3软件进行Meta分析。结果最终纳入8篇文献,共包含1563名患者,其中ATAAD术前低氧血症的患者719名,发生率为46.0%。Meta分析结果显示:C-反应蛋白(CRP)(P=0.005)、体质指数(BMI)(P=0.01)、白细胞介素-6(IL-6)(P<0.0001)和吸烟史(P=0.03)是ATAAD术前发生低氧血症的独立危险因素。结论ATAAD患者术前合并有高CRP、高BMI、高IL-6、吸烟史是其发生低氧血症的独立危险因素。医务人员应高度重视以上因素,早期预警,加强围术期的管理和治疗,提高患者临床预后。

Objective To explore the risk factors of preoperative hypoxemia in patients with acute Stanford type A aortic dissection(ATAAD).Methods We searched the CNKI,Wang fang,PubMed and other databases from inception to April 2021.Two researchers independently selected studies,extracted data,and assessed methodologic quality.Revman 5.3 software was used for meta-analysis.Results A total of 1563 patients were included in 8 studies,of which 719 patients had hypoxemia before ATAAD surgery,with an incidence of 46.0%.The meta-analysis showed that the C-reactive protein(CRP)(P=0.005),body mass index(BMI)P=0.01),interleukin 6(IL-6)(P<0.0001)and smoking history(P=0.03)were independent risk factors for hypoxemia before ATAAD surgery.Conclusion Existing studies have shown that CRP,BMI,IL-6,and smoking history were independent risk factors for hypoxemia in patients before ATAAD surgery.Clinicians should attach great importance to the above factors,give early warnings,and strengthen perioperative management to improve the clinical prognosis of patients.