中国医学前沿杂志（电子版）2024，Vol.16Issue(7)：80-86,7.DOI:10.12037/YXQY.2024.07-10
急性Standford A型主动脉夹层术前低氧血症对术后消化道出血的影响分析
Analysis on effect of preoperative hypoxemia on postoperative gastrointestinal bleeding in patients with acute type A aortic dissection
摘要
Abstract
Objective To investigate the association between preoperative hypoxemia and postoperative gastrointestinal bleeding(GIB)in patients with acute type A aortic dissection(ATAAD),and provide reference for the prediction,diagnosis and treatment of postoperative GIB for ATAAD patients.Methods A retrospective cohort study was conducted to analyze the perioperative clinical data of 123 patients with ATAAD.The mean with standard deviation was used to describe the continuous variable,and the t test was used for the comparison between groups.Logistic regression analysis was performed to investigate the association between preoperative hypoxemia and postoperative GIB.In addition,a prediction model for postoperative GIB for ATAAD patients was established based on perioperative indicators,and the predictive efficiency of the model was evaluated by calculating the area under the receiver operating characteristic curve(AUC).Results Among all included patients,the incidence of preoperative hypoxemia was 26.0％(32/123),and the incidence of postoperative GIB was 8.1％(10/123).Univariate Logistic regression analysis showed that preoperative hypoxemia(P=0.004),C-reactive protein(P=0.021),interleukin-6(P=0.020)and intraoperative circulatory arrest time(P=0.001)were significantly associated with postoperative GIB.Multivariate Logistic regression analysis showed that preoperative hypoxemia(P=0.024)and intraoperative deep hypothermia circulatory arrest time(P=0.01)were independent risk factors for postoperative GIB in patients with ATAAD.The clinical prediction model based on preoperative hypoxemia,aortic dissection involving mesenteric artery and intraoperative deep hypothermia circulatory arrest time could well predict the risk of postoperative GIB(AUC=0.913).Conclusions Preoperative hypoxemia and intraoperative deep hypothermia circulatory arrest time are independent risk factors for postoperative GIB in AT A AD patients.关键词
急性A型主动脉夹层/消化道出血/低氧血症/危险因素/临床预测模型Key words
Acute type A aortic dissection/Gastrointestinal bleeding/Hypoxemia/Risk factors/Clinical prediction models引用本文复制引用
李嘉骏,张宇聪,王靖,周永智,胡敏..急性Standford A型主动脉夹层术前低氧血症对术后消化道出血的影响分析[J].中国医学前沿杂志（电子版）,2024,16(7):80-86,7.基金项目
湖北省自然科学基金计划项目(2023AFB672) the Hubei Provincial Natural Science Foundation(2023AFB672) （2023AFB672）
