Clinically,it is widely recognized that surgical treatment is the preferred and reliable option for Stanford type A aortic dissection.Stanford type A aortic dissection is an emergent and serious cardiovascular disease...Clinically,it is widely recognized that surgical treatment is the preferred and reliable option for Stanford type A aortic dissection.Stanford type A aortic dissection is an emergent and serious cardiovascular disease characterized with an acute onset,poor prognosis,and high mortality.However,the incidences of postoperative complications are relatively higher due to the complexity of the disease and its intricate procedure.It has been considered that hypoxemia,one of the most common postoperative complications,plays an important role in having a worse clinical prognosis.Therefore,the effective intervention of postoperative hypoxemia is significant for the improved prognosis of patients with Stanford type A aortic dissection.展开更多
Objectives Inflammation has been shown to be related with acute aortic dissection （AAD）. The present study aimed to evaluate the association of white blood cell counts （WI3Cc） on admission with both in-hospital an...Objectives Inflammation has been shown to be related with acute aortic dissection （AAD）. The present study aimed to evaluate the association of white blood cell counts （WI3Cc） on admission with both in-hospital and long-term all-cause mortality in patients with uncom- plicated Stanford type B AAD. Methods From 2008 to 2010, a total of 377 consecutive patients with uncomplicated type B AAD were enrolled and then followed up. Clinical data and WBCc on admission were collected. The primary end points were in-hospital death and long-term all-cause death. Results The in-hospital death rate was 4.2%, and the long-term all-cause mortality rate was 6.9% during a median follow-up of 18.9 months. WBCc on admission was identified as a risk factor for in-hospital death by univariate Cox regression analysis as both a continuous variable and a categorical variable using a cut off of 11.0 × 109 cell/L （all P 〈 0.05）. After adjusting for age, sex and other risk factors, elevated admission WBCc was still a significant predictor for in-hospital death as both a continuous variable [hazard ratio （HR）： 1.052, 95% CI： 1.024-1.336, P = 0.002] and a categorical variable using a cut off of 11.0 × 109 cell/L （HR： 2.056, 95% CI： 1.673-5.253, P = 0.034）. No relationship was observed between WBCc on admission and long-term all-cause death. Conclusions Our results indicate that elevated WBCc upon admission might be used as a predictor for increased risk of in-hospital death in uncomplicated type B AAD. There might be no predictive value of WBCc for the long-term survival of type B AAD.展开更多
Objective:To determine the clinical value of rhBNP in the treatment of patients with Stanford type B aortic dissection.Methods:From June 2018 to October 2021,162 patients with Stanford type B aortic dissection were se...Objective:To determine the clinical value of rhBNP in the treatment of patients with Stanford type B aortic dissection.Methods:From June 2018 to October 2021,162 patients with Stanford type B aortic dissection were selected from the Cardiology Department of Henan Provincial Chest Hospital and randomly divided into two groups:control group(81 patients)and observation group(81 patients).The patients in the control group were treated with conventional therapy.On the basis of the control group,the patients in the observation group were treated with rhBNP.The cardiac function,renal function,pulmonary function,and inflammatory indices before and after treatment for 72 hours,as well as the incidence of adverse reactions between the two groups were compared.Results:After treatment,the cardiac function(LVEF and NT-pro BNP),renal function(urine output for 24 hours,SCr,and Cys-C),pulmonary function(PaO_(2),SPO_(2),and PaO_(2)/FiO_(2)),and inflammatory(IL-6,hsCRP,and MCP-1)indices of the observation group improved significantly compared to those of the control group(p<0.05).Conclusion:rhBNP can improve cardiac function,renal function,and pulmonary function,as well as alleviate inflammation in patients with Stanford type B aortic dissection.Hence,in the treatment of patients with Stanford type B aortic dissection,rhBNP provides multi-organ protection.展开更多
Objective To summarize the experiences of ligating left subclavian artery ( LSA ) in total arch peplacement and stented elephant trunk implantation for Stanford type A aortic dissection patients with difficulty in exp...Objective To summarize the experiences of ligating left subclavian artery ( LSA ) in total arch peplacement and stented elephant trunk implantation for Stanford type A aortic dissection patients with difficulty in exposing the LSA. Methods Total arch replacement and stented elephant trunk implantation were performed on 79 consecutive展开更多
Accelerated rehabilitation surgery (ERAS) can promote postoperative recovery and reduce postoperative complications by minimizing surgically related stress, and its efficacy and safety in acute aortic dissection surge...Accelerated rehabilitation surgery (ERAS) can promote postoperative recovery and reduce postoperative complications by minimizing surgically related stress, and its efficacy and safety in acute aortic dissection surgery have been demonstrated. However, due to the particularity of acute aortic dissection, studies on the application of accelerated rehabilitation surgery in acute aortic dissection are relatively rare and there are great differences among different studies. This study adopts the method of evidence-based nursing practice accelerate rehabilitation cluster of surgical nursing strategy developed and applied to the patients with primary acute aortic dissection and adopts “accelerate rehabilitation cluster of surgical nursing strategy” and “accelerated rehabilitation cluster of surgical nursing strategies in patients with acute aortic dissection in clinical intervention”, the new nursing concept and organic combination of traditional nursing measures, using the optimal cluster nursing intervention mode, to explore the safety, effectiveness and feasibility of the intervention mode in the perioperative period of the original acute aortic dissection in patients’ cluster intervention, to accelerate the rehabilitation surgery in acute aortic dissection in the clinical care to provide a scientific basis for the operation.展开更多
文摘Clinically,it is widely recognized that surgical treatment is the preferred and reliable option for Stanford type A aortic dissection.Stanford type A aortic dissection is an emergent and serious cardiovascular disease characterized with an acute onset,poor prognosis,and high mortality.However,the incidences of postoperative complications are relatively higher due to the complexity of the disease and its intricate procedure.It has been considered that hypoxemia,one of the most common postoperative complications,plays an important role in having a worse clinical prognosis.Therefore,the effective intervention of postoperative hypoxemia is significant for the improved prognosis of patients with Stanford type A aortic dissection.
基金We are very grateful to the patients and doctors who participated in the study and for the help and co-operation of the clinic staff. This work was supported by a grant from the National Natural Science Foundation of China to Dr. FAN XH （No. 81570430）.
文摘Objectives Inflammation has been shown to be related with acute aortic dissection （AAD）. The present study aimed to evaluate the association of white blood cell counts （WI3Cc） on admission with both in-hospital and long-term all-cause mortality in patients with uncom- plicated Stanford type B AAD. Methods From 2008 to 2010, a total of 377 consecutive patients with uncomplicated type B AAD were enrolled and then followed up. Clinical data and WBCc on admission were collected. The primary end points were in-hospital death and long-term all-cause death. Results The in-hospital death rate was 4.2%, and the long-term all-cause mortality rate was 6.9% during a median follow-up of 18.9 months. WBCc on admission was identified as a risk factor for in-hospital death by univariate Cox regression analysis as both a continuous variable and a categorical variable using a cut off of 11.0 × 109 cell/L （all P 〈 0.05）. After adjusting for age, sex and other risk factors, elevated admission WBCc was still a significant predictor for in-hospital death as both a continuous variable [hazard ratio （HR）： 1.052, 95% CI： 1.024-1.336, P = 0.002] and a categorical variable using a cut off of 11.0 × 109 cell/L （HR： 2.056, 95% CI： 1.673-5.253, P = 0.034）. No relationship was observed between WBCc on admission and long-term all-cause death. Conclusions Our results indicate that elevated WBCc upon admission might be used as a predictor for increased risk of in-hospital death in uncomplicated type B AAD. There might be no predictive value of WBCc for the long-term survival of type B AAD.
基金2018 Joint Construction Project of Henan Medical Science and Technology Research Plan(Project Number:2018010035)。
文摘Objective:To determine the clinical value of rhBNP in the treatment of patients with Stanford type B aortic dissection.Methods:From June 2018 to October 2021,162 patients with Stanford type B aortic dissection were selected from the Cardiology Department of Henan Provincial Chest Hospital and randomly divided into two groups:control group(81 patients)and observation group(81 patients).The patients in the control group were treated with conventional therapy.On the basis of the control group,the patients in the observation group were treated with rhBNP.The cardiac function,renal function,pulmonary function,and inflammatory indices before and after treatment for 72 hours,as well as the incidence of adverse reactions between the two groups were compared.Results:After treatment,the cardiac function(LVEF and NT-pro BNP),renal function(urine output for 24 hours,SCr,and Cys-C),pulmonary function(PaO_(2),SPO_(2),and PaO_(2)/FiO_(2)),and inflammatory(IL-6,hsCRP,and MCP-1)indices of the observation group improved significantly compared to those of the control group(p<0.05).Conclusion:rhBNP can improve cardiac function,renal function,and pulmonary function,as well as alleviate inflammation in patients with Stanford type B aortic dissection.Hence,in the treatment of patients with Stanford type B aortic dissection,rhBNP provides multi-organ protection.
文摘Objective To summarize the experiences of ligating left subclavian artery ( LSA ) in total arch peplacement and stented elephant trunk implantation for Stanford type A aortic dissection patients with difficulty in exposing the LSA. Methods Total arch replacement and stented elephant trunk implantation were performed on 79 consecutive
文摘Accelerated rehabilitation surgery (ERAS) can promote postoperative recovery and reduce postoperative complications by minimizing surgically related stress, and its efficacy and safety in acute aortic dissection surgery have been demonstrated. However, due to the particularity of acute aortic dissection, studies on the application of accelerated rehabilitation surgery in acute aortic dissection are relatively rare and there are great differences among different studies. This study adopts the method of evidence-based nursing practice accelerate rehabilitation cluster of surgical nursing strategy developed and applied to the patients with primary acute aortic dissection and adopts “accelerate rehabilitation cluster of surgical nursing strategy” and “accelerated rehabilitation cluster of surgical nursing strategies in patients with acute aortic dissection in clinical intervention”, the new nursing concept and organic combination of traditional nursing measures, using the optimal cluster nursing intervention mode, to explore the safety, effectiveness and feasibility of the intervention mode in the perioperative period of the original acute aortic dissection in patients’ cluster intervention, to accelerate the rehabilitation surgery in acute aortic dissection in the clinical care to provide a scientific basis for the operation.
