The analysis on the causes and treatment stretagies of Stanford A aortic dissection
10.3760/cma.j.issn.1008-6315.2012.05.028
- VernacularTitle:Stanford A型主动脉夹层围术期低氧的原因分析及治疗策略
- Author:
Yinghua WANG
;
Song XUE
;
Genxing XU
;
Ritai HUANG
;
Bo XIE
- Publication Type:Journal Article
- Keywords:
Aortic dissection;
Surgical operation;
Hypoxia
- From:
Clinical Medicine of China
2012;28(5):531-533
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the reasons of perioperative hypoxia in Stanford A aortic dissection,and summarize its management strategies.Methods From Dec.2005 to Jul.2011,sixty four patients underwent surgery for acute type A aortic dissection,of which 9 cases were with chronic dissection and 55 cases with emergent ones.Preoperative oxygen fraction ratio( PaO2/FiO2 )in 51 cases was lower than 200 mm Hg.All of them underwent the surgery with the help of deep hypothermia cardiac arrest technique.Results Three cases died.Thirty-three cases could not live without ventilation during the first 72 h because of continuous hypoxia ( PaO2/FiO2 ＜ 200 mm Hg).One case underwent tracheotomy and auxiliary ventilation for 9 days.The rest were live without ventilation after auxiliary ventilator for 72 - 120 hrs.The data showed that postoperative hypoxia was related to preoperative hypoxia (oxygen fraction ratio ＜ 200 mm Hg),BMI,acute onset,hypothermia cardiac arrest time,and transfusion more than 3000 ml ( P ＜ 0.05 ).Conclusion Great attention should be paid to the perioperative hypoxia-related factors in Stanford A dissection,which will be helpful to improve prognosis.
