Objective To explore the risk factors for postoperative hypoxemia in patients undergoing Stanford type A aortic dissection surgery.Methods The clinical data of 77 patients with Stanford type A aortic dissection surgery were analyzed retrospectively.Among the patients, 40 patients occurred hypoxemia(hypoxemia group),and 37 patients did not occur hypoxemia(non-hypoxemia group).The preoperative,intraoperative and postoperative clinical data were compared between 2 groups,and the independent risk factors for postoperative hypoxemia were analyzed by multiple Logistic regression analysis.Results The incidence of postoperative hypoxemia in patients with Stanford type A aortic dissection was 51.9% (40/77).The multiple Logistic regression analysis result showed that age (OR =1.088,95% CI 1.018-1.164,P=0.013),body mass index≥25 kg/m2(OR=6.495,95% CI 1.327-31.789,P=0.021),pericardial effusion(OR=6.384,95% CI 1.426-28.576,P=0.015),white blood cell count(OR=1.289,95% CI 1.033-1.609,P=0.024)and using recombinant human coagulationⅦa (OR = 23.757, 95% CI 2.849 - 198.085, P = 0.003) were the independent predictive factors for postoperative hypoxemia in patients with Stanford type A aortic dissection.Conclusions The postoperative hypoxemia in patients with Stanford type A aortic dissection is related with perioperative systemic inflammation, especially in obese patients who should be given anti-inflammatory treatment during perioperative period.Control of bleeding and reducing the recombinant human coagulationⅦa as far as possible can reduce the incidence of postoperative hypoxemia.