喀什地区主动脉夹层发病特点及院内死亡危险因素分析

Analysis of pathogenic characteristics and risk factors of death in hospital for the patients with aortic dissection in Kashgar

目的探讨喀什地区主动脉夹层(aortic dissection,AD)患者的发病特点,并对院内死亡危险因素进行分析。方法采用回顾性分析,选取2018年12月至2021年12月喀什地区第一人民医院收治的295例AD患者作为研究对象,分析其发病特点、临床特征及院内死亡危险因素。结果喀什地区AD患者发病年龄(54.12±12.79)岁,其临床症状以胸痛、背痛、腹痛为主,常合并高血压、主动脉硬化、主动脉瘤。Stanford A型及B型AD的临床症状体征和并发症比较差异有统计学意义(P<0.05)。手术干预能明显降低AD的总死亡率(P<0.05)。对与院内死亡的相关因素进行Logistic回归分析,结果显示患者合并心包积液、低血压或休克、外周血白细胞数升高为院内AD患者死亡的危险因素(P<0.05)。结论喀什地区AD患者的发病特点和临床特征与多个因素相关。合并心包积液、低血压或休克、外周血白细胞数升高均为喀什地区院内AD患者死亡的独立危险因素,手术治疗是院内AD患者死亡的保护因素。

Objective To investigate the characteristics of the patients with aortic dissection(AD)in Kashgar and analyze the risk factors of death in the hospital.Methods 295 patients with aortic dissection treated in the First People’s Hospital of Kashgar from December 2018 to December 2021 were collected as research subjects by using retrospective cross⁃sectional study method,and to analyze pathogenic and clinical features,as well as risk factors of death in the hospital.Results The average age of the patients with aortic dissection in Kashgar was(54.12±12.79)years,with main clinical symptoms of chest,back and abdomen pains complicated with high pressure,aortic sclerosis and aortic aneurysm.The characteristics of Stanford A type and Stanford B type aortic dissection were different,and surgery could significantly reduce the overall mortality of aortic dissection.Logistic regression analysis showed that complication with pericardial effusion,hypotension or shock,and elevated peripheral white blood cell count were all risk factors of death in the hospital.Conclusion The morbidity and clinical characteristics of the patients with aortic dissection in Kashgar are related to multiple factors.Complication with pericardial effusion,myocardial infarction,hypotension or shock,and elevated peripheral white blood cell count are all independent risk factors of death in the hospital,and surgery is a protective factor for death in the hospital,which will provide an evidence for timely treatment of the disorder.