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在手术治疗的急性A型大动脉剖析中,人口结构和结果的变化:一个15年的区域经验
Elisa Mikus1, Mariafrancesca Fiorentino1, Diego Sangiorgi1
1Cardiovascular Department, Maria Cecilia Hospital, GVM Care & Research, 48033 Cotignola, Italy.
Medicina (Kaunas, Lithuania)
|December 31, 2025
概括
经过手术治疗的急性A型大动脉剖析 (ATAAD) 患者在15年内出现的临床前危险状况较少. 尽管风险得分较高,但女性的生存率与男性相似,这挑战了之前的发现.
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
- 血管外科 血管外科
背景情况:
- 急性甲动脉解剖A型 (ATAAD) 是危及生命的紧急情况,需要立即进行手术.
- 诊断,手术技术和术后护理方面的进步已经发展出了患者的个人资料和结果.
- ATAAD临床特征和手术结果的时间趋势需要持续分析.
研究的目的:
- 分析15年间手术治疗的ATAAD患者临床形状和结果的时间趋势.
- 评估患者人口统计,手术前条件和手术结果的变化.
- 为了调查ATAAD手术的结果的基于性别的差异.
主要方法:
- 从2010年到2024年,对427名连续接受急性斯坦福A型大动脉剖析或急性内壁血瘤 (IMH) 紧急手术的患者进行了回顾性审查.
- 排除患有慢性穿透性动脉样性或创伤病因的患者.
- 使用线性回归和Cochran-Armitage趋势测试对人口统计学,临床和外科手术期间变量的分析.
主要成果:
- 随着时间的推移,观察到手术前输管和休克发生率的显著下降.
- 平均EuroSCORE显示非显著增加,年龄或其他基线参数没有显著变化.
- 尽管女性年龄较大,EuroSCORE值较高,但她们的术后死亡率与男性相似,与一些报告形成鲜明对比.
结论:
- 接受ATAAD手术的患者出现了不太严重的手术前条件,表明早期诊断和改善的管理.
- 尽管手术风险得分增加,但该区域计划中的女性的短期存活率与男性相似.
- 多变量分析表明,性别与住院死亡率有着依赖性关联.
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