在接受大动脉手术的患者中出现术后肺部并发症:单中心回顾性研究
Yan Yan1,2, Xuebing Zhang1,3, Yuntai Yao1
1Department of Anesthesiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
Medicine
|September 29, 2023
概括
手术后肺部并发症 (PPC) 影响近30%的患者接受心血管手术急性A型大动脉解剖. 风险因素包括糖尿病,功能障碍和更长的绕道时间,导致结果较差.
科学领域:
- 心血管外科心血管外科
- 胸部外科手术 胸部外科手术
- 肺部医学 肺部医学
背景情况:
- 手术后的肺部并发症 (PPC) 在心血管手术后很常见.
- 急性A型大动脉解剖 (ATAAD) 需要复杂的手术,增加并发症风险.
研究的目的:
- 为了确定PPC在ATAAD患者中发生的发生率,这些患者接受了用冷大象体 (TAR + FET) 进行全大动脉门置换.
- 确定该患者群体中PPCs的独立风险因素.
- 为了比较带有PPC和没有PPC的患者之间的术后结果.
主要方法:
- 在2021年1月至2022年8月期间接受了TAR + FET手术的305名ATAAD患者的回顾性分析.
- 患者被分为PPC和非PPC组.
- 统计分析,包括后勤回归,用于识别风险因素并比较结果.
主要成果:
- PPC的总体发病率为29.2%.
- PPC的独立风险因素包括糖尿病病史,功能障碍,手术前的SPO2<90%,延长的心肺绕道,以及大量的新鲜冷血和血小板缩物.
- 患有PPC的患者经历了显著更长的通风时间,ICU停留和住院停留,尽管在医院死亡率没有差异.
结论:
- 在接受TAR + FET手术的ATAAD患者中,PPCs很常见,并且与多因素原因有关.
- PPC的发生显著影响短期术后结果,突出需要进一步调查和预防策略.
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