肾下腹主动脉重建术危险因素分析

Analysis of the risk factors in the reconstruction of infrarenal abdominal aorta

目的 研究影响肾下腹主动脉重建手术的危险因素 ,探讨防治策略。方法 收集 340例行肾下腹主动脉重建术的患者 ,将年龄、性别、病种、吸烟史、高血压、糖尿病、心电图异常、肺功能不全、肥胖、肾功能不全、腹腔手术史、手术时间作为手术的危险因素 ,用Logistic多因素回归分析找出独立的危险因素。结果 手术总死亡率为 7.6 4 % (2 6 / 340例 ) ,手术并发症发生率为 2 2 .35 % (76 / 340例 )。Logistic多因素回归分析显示年龄 (P <0 .0 0 5 )、术前肾功能不全 (P <0 .0 5 )、心电图ST段异常 (P <0 .0 5 )、高血压 (P <0 .0 5 )、长期大量吸烟史 (P <0 .0 5 )、腹部手术史 (P <0 .0 0 5 )和手术时间 (P <0 .0 1)是肾下腹主动脉重建手术独立的危险因素。

Objective To identify the perioperative variables which may influence the mortality of the reconstruction of infrarenal abdominal aorta. Methods During a 13 year period (from 1990 to 2003), 340 infrarenal abdominal aortas'reconstructions were performed. Risk factors as age, gender, disease, smoking, hypertension, diabetes mellitus, coronary artery disease, respiratory dysfunction, renal dysfunction, abdominal operative history and operation duration were evaluated. Results The perioperative mortality was 7.64% (26/340) and the morbidity was 22.35% (76/340) . On multivariate analysis, age ( P < 0.005), preoperative renal dysfunction ( P <0.05), coronary artery disease ( P <0.05), hypertension ( P <0.05), smoking ( P <0.05), abdominal operation history ( P <0.005) and operative duration ( P <0.01) were the significant predictors of poor operative outcome. Conclusion To assess the risk factors comprehensively before operation and to adopt preventive methods would likely reduce the operative risk.