中国体外生命支持2026，Vol.24Issue(2)：122-126,131,6.DOI:10.13498/j.cnki.chin.j.ecls.2026.02.07
急性A型主动脉夹层术后低氧血症预后及危险因素分析
Prognosis and independent risk factors of hypoxemia after acute type A aortic dissection surgery
摘要
Abstract
Objective To investigate the incidence,short-term prognosis and independent risk factors of hypoxemia after acute type A aortic dissection(ATAAD)surgery.Methods Consecutive patients with ATAAD who underwent surgical treatment at Beijing Anzhen Hospital of Capital Medical University from January 2023 to July 2023 were enrolled.According to the presence or absence of hypoxemia within 48 hours after surgery,patients were divided into a hypoxemia group(oxygen-ation index,arterial partial pressure of oxygenfraction of inspired oxygen PaO2/FiO2≤200 mmHg)and a control group(PaO2/FiO2>200 mmHg).The clinical features,surgical data and short-termoutcomes were compared between the two groups.Multi-variable logistic regression analysis was performed to identify independent risk factors for postoperative hypoxemia.Results A total of 145 patients were included,with an average age of 51.82±10.65 years.A total of 97 patients(66.9%)developed hypox-emia.Compared with the control group,the hypoxemia group had a significantly longer ICU stay(3.5 d vs.1.5 d,P<0.001)and duration of mechanical ventilation(19.5 h vs.12 h,P<0.001),as well as significantly higher rates of noninvasive ventilator use(27.8%vs.10.4%,P=0.017),infection(27.8%vs.2.1%,P<0.001),tracheotomy(10.3%vs.0%,P=0.031),visceral ischemia(16.5%vs.4.2%,P=0.035),continuous renal replacement therapy(CRRT)(16.5%vs.4.2%,P=0.035),and acute cerebrovas-cularevents(13.4%vs.0%,P=0.005).However,there was no significant difference in in-hospital mortality between the two groups(5.2%vs.0%,P=0.171).Multivariable logistic regression showed that age(OR=1.079,95%CI:1.027～1.135),body mass index(BMI)(OR=1.406,95%CI:1.203～1.643),preoperative C-reactive protein(CRP)(OR=1.020,95%CI:1.006～1.035),intraoperative peak lactate(OR=1.670,95%CI:1.025～2.719)and postoperative 48h blood transfusion(OR=1.013,95%CI:1.000～1.022)were independent predictors of hypoxemia after ATAAD surgery(P<0.05).Conclusion Postoperative hypox-emia is associated with a significantly increased risk of postoperative complications.Age,BMI,preoperative CRP,intraoperative peak lactate and postoperative 48h blood transfusion volume are independent risk factors.Early identification and intervention may improve prognosis.关键词
急性A型主动脉夹层/大血管手术/低氧血症/危险因素/预后Key words
acute type A aortic dissection/great vessel surgery/hypoxemia/risk factors/prognosis引用本文复制引用
时亚丽,金祺,李呈龙,刘楠,王红,贾明,侯晓彤..急性A型主动脉夹层术后低氧血症预后及危险因素分析[J].中国体外生命支持,2026,24(2):122-126,131,6.基金项目
北京市高层次公共卫生技术人才建设项目(领军人才-03-05) （领军人才-03-05）
