Zhao Yongbo, Yue Yuehong, Wang Yanzhi, Zhao Weichao, Feng Guangxing
Department of Cardiovascular Surgery, Fourth Hospital of Hebei Medical University Shijiazhuang, Hebei Province, China.
Department of Neurology, Hebei General Hospital Shijiazhuang, Hebei Province, China.
Am J Transl Res. 2021 Jun 15;13(6):7318-7326. eCollection 2021.
To explore the risk factors for postoperative acute respiratory distress syndrome (ARDS) in Stanford type A acute aortic dissection (AAD) patients.
This study included 64 patients with Stanford type A AAD who underwent Sun's procedure. The patients were divided into an ARDS group (PaO/FiO < 200 mmHg) and a non-ARDS group (PaO/FiO ≥ 200 mmHg). We compared the patients' perioperative clinical features in the two groups. A multivariate binary logistic regression was used to analyze the risk factors for ARDS in the Stanford type A AAD patients.
The incidence of postoperative ARDS was 56.25%. There were 13 deaths in the 6-month follow-up, including 8 in the ARDS group and 5 in the non-ARDS group. There were differences in the body mass index (BMI) levels, the times from onset to operation, the preoperative white blood cell counts, the preoperative hemoglobin levels, the preoperative alanine aminotransferase levels, the preoperative blood creatinine levels, the preoperative PaO/FiO, intraoperative blood transfusion volumes, the assisted mechanical ventilation times, and the durations of the intensive care unit stays between the two groups (all P < 0.05). The logistic regression analysis revealed that a BMI ≥ 25 kg/m, a time from onset to operation ≥ 24 hours, a preoperative white blood cell count ≥ 10×10/L, and a preoperative PaO/FiO < 300 mmHg were the independent risk factors for postoperative ARDS in patients with Stanford type A AAD.
ARDS occurs often in Stanford type A AAD patients. A BMI ≥ 25 kg/m, a time from onset to operation ≥ 24 hours, a preoperative white blood cell count ≥ 10×10/L, and a preoperative PaO/FiO < 300 mmHg are the independent risk factors for postoperative ARDS in these patients.
探讨 Stanford A 型急性主动脉夹层（AAD）患者术后急性呼吸窘迫综合征（ARDS）的危险因素。
本研究纳入 64 例行孙氏手术的 Stanford A 型 AAD 患者。将患者分为 ARDS 组（动脉血氧分压/吸入氧浓度[PaO/FiO]<200 mmHg）和非 ARDS 组（PaO/FiO≥200 mmHg）。比较两组患者围手术期的临床特征。采用多因素二元逻辑回归分析 Stanford A 型 AAD 患者发生 ARDS 的危险因素。
术后 ARDS 的发生率为 56.25%。6 个月随访期间有 13 例死亡，其中 ARDS 组 8 例，非 ARDS 组 5 例。两组患者的体重指数（BMI）水平、发病至手术时间、术前白细胞计数、术前血红蛋白水平、术前谷丙转氨酶水平、术前血肌酐水平、术前 PaO/FiO、术中输血量、机械通气辅助时间以及重症监护病房停留时间存在差异（均 P<0.05）。逻辑回归分析显示，BMI≥25 kg/m²、发病至手术时间≥24 小时、术前白细胞计数≥10×10⁹/L 以及术前 PaO/FiO<300 mmHg 是 Stanford A 型 AAD 患者术后发生 ARDS 的独立危险因素。
ARDS 在 Stanford A 型 AAD 患者中常有发生。BMI≥25 kg/m²、发病至手术时间≥24 小时、术前白细胞计数≥10×10⁹/L 以及术前 PaO/FiO<300 mmHg 是这些患者术后发生 ARDS 的独立危险因素。
