主动脉夹层术后低氧血症发生的危险因素分析

Risk factors for hypoxemia after aortic dissection operation

目的分析主动脉夹层(AD)术后低氧血症发生的危险因素。方法抽取2020年7月至2023年3月于南阳市中心医院行孙氏手术治疗的AD患者112例,依据术后是否发生低氧血症分组,40例发生低氧血症[动脉血氧分压(PaO2)/吸入氧浓度(FiO2)<200 mmHg,1 mmHg=0.133 kPa]的患者设为观察组,72例未发生低氧血症(PaO2/FiO2≥200 mmHg)的患者设为对照组。应用单因素、多因素Logistic回归分析探讨AD术后低氧血症的危险因素。结果观察组体质指数(BMI)、术中输血、白细胞计数(WBC)、C反应蛋白(CRP)、深低温停循环时间与对照组比较,差异有统计学意义(P<0.05)。Logistic回归分析结果显示,BMI、术中输血、WBC、CRP、深低温停循环时间是AD术后发生低氧血症的危险因素(OR=2.19、2.33、2.10、2.55、1.86,P均<0.05)。结论 AD患者孙氏手术后低氧血症的发生与BMI高、术中输血、WBC及CRP高表达、深低温停循环时间长等因素有关。

Objective To analyze the risk factors for hypoxemia after aortic dissection(AD)operation.Methods A total of 112 patients with AD who underwent Sun’s surgery in Nanyang Central Hospital from July 2020 to March 2023 were selected,and they were grouped according to whether hypoxemia occurred after operation.Forty patients with hypoxemia who were with arterial partial pressure of oxygen(PaO2)/inspired oxygen concentration(FiO2)<200 mmHg(1 mmHg=0.133 kPa)were set as the observation group.Moreover,72 patients without hypoxemia(PaO2/FiO2≥200 mmHg)were set as the control group.Univariate and multivariate logistic regression analysis were used to investigate the risk factors for hypoxemia after AD operation.Results There were significant differences in body mass index(BMI),intraoperative blood transfusion,white blood cell count(WBC),C-reactive protein(CRP)and cryogenic cycle arrest time between the observation group and the control group(P<0.05).Results of Logistic regression analysis showed that BMI,intraoperative blood transfusion,WBC,CRP,and cryogenic cycle arrest time were risk factors for hypoxemia after AD operation(OR=2.19,2.33,2.10,2.55,1.86;all P<0.05).Conclusions The occurrence of hypoxemia after Sun’s surgery in patients with AD is related to factors,such as high BMI,intraoperative blood transfusion,high expression of WBC and CRP,and long cryogenic cycle arrest time.