a型主动脉夹层患者术前猝死相关因素分析.docVIP

精品论文 参考文献 A型主动脉夹层患者术前猝死相关因素分析 三峡大学人民医院amp;宜昌市第一人民医院心胸外科 湖北 宜昌 邮编：443000 作者简介：李奎（1982.05-），男，汉族，湖北宜昌人，主治医师，外科学硕士，研究方向：心血管外科、胸外科。 [摘要]目的：探讨A型主动脉夹层患者术前猝死的危险因素，指导临床实践。方法：调取2010年10月-2015年10月期间我科收治的48例超声心动图和增强CT明确显示升主动脉受累的A型主动脉夹层患者资料，其中10例术前猝死，作为实验组；其余38例未发生术前猝死，作为对照组。摘录患者的一般资料、身体质量指数（BMI）、血脂相关生化指标、超声心动图等数据，查阅相关文献，列出与A型主动脉夹层术前猝死关系密切的变量。先将各变量用单因素分析以P＜0.25为标准进行筛选，将筛选出的变量进一步用多因素Logistic回归分析得出危险因素。结果：单因素???析显示：以P＜0.25为标准，筛选进入多因素Logistic回归分析的变量有BMI、血清总胆固醇、夹层累及主动脉窦部及假腔血栓化四个因素。进一步多因素Logistic回归分析显示：其中，BMI和夹层累及主动脉窦部两个因素与A型主动脉夹层患者术前猝死呈正相关，而假腔血栓化与术前猝死呈负相关趋势。结论：临床医师在A型主动脉夹层患者的救治中应快速准确评估BMI、夹层累及主动脉窦部及假腔血栓化等因素，并选择合适的手术方案和最佳手术时机。 关键词：A型主动脉夹层；术前猝死；危险因素 【中图分类号】R423【文献标识码】A【文章编号】1001-5213(2016)08-0267-01 Analysis of Related Factors of Preoperative Sudden Death in Patients with Type A Aortic Dissection Likui,Zhang Yulin (Department of Cardiothoracic Surgery，Renmin Hospital of Three Gorges University amp; The First Peoples Hospital of Yichang，Yichang,Hubei,443000) [abstract] objective: to study the type A aortic dissection in patients with preoperative risk factors of sudden death, to guide clinical practice. Methods: in October 2010 - to be obtained in October 2015 of 48 cases admitted in our department during echocardiographic and enhanced CT clearly show the ascending aorta in patients with type A aortic dissection, including 10 cases of preoperative death, as the experimental group; The remaining 38 cases of preoperative death not occurring, as control group. Excerpts from the patients general information, body mass index (BMI), blood lipid related biochemical indicators, such as echocardiography data, consulting relevant literature, list and type A aortic dissection preoperative variables closely related to sudden death. To each variable with single factor analysis with P lt; 0.25 for the standard screening, will filter out variables using multiariable Logistic regression analysis further risk factors. Results: single factor analysis showed that: with P lt; 0.25 for the standard, filt