急性主动脉夹层弓部手术后谵妄的临床研究-东南大学学报医学版

急性主动脉夹层弓部手术后谵妄的临床研究

单位：郑州大学第二附属医院心脏大血管外科, 河南郑州 450014

分类号：R543.16;R654.3

出版年·卷·期（页码）：2018·37·第二期（259-262）

摘要：

目的：研究急性主动脉夹层弓部手术后谵妄的危险因素。方法：回顾我院2014年5月至2017年5月心外科成功实施弓部置换手术的A型主动脉夹层患者资料，采用意识错乱评估方法进行谵妄诊断，根据有无术后谵妄分为两组（谵妄组n=32、非谵妄组n=76），并结合临床资料分析术后谵妄的危险因素。结果：主动脉夹层弓部置换术手术后谵妄的发生率为29.6%。多因素Logsistic回归分析结果表明手术后低氧血症、术中平均动脉压谷值<50 mmHg及椎动脉缺血是术后谵妄的危险因素。结论：手术后低氧血症、术中平均动脉压谷值小于50 mmHg及椎动脉缺血是夹层围手术期谵妄的独立危险因素。

Objective:To study the risk factors of delirium after aortic arch operation for acute aortic dissection.Methods:The patients' data with aortic arch replacement for type A aortic dissection from May 2014 to May 2017 in our department of cardiac surgery were reviewed,and consciousness disorder assessment method for delirium diagnosis was used.According to whether postoperative delirium occured, the patients were divided into two groups.And the clinical data were used to analyze the risk factors of postoperative delirium. Results:The incidence of delirium after aortic dissection operation was 29.6%.Multivariate Logistic regression analysis showed that postoperative hypoxemia, the valley value of intraoperative mean arterial pressure with less than 50 mmHg, vertebral artery ischemia were risk factors for postoperative delirium. Conclusion:Postoperative hypoxemia, intraoperative mean arterial pressure valley value that is less than 50 mmHg, vertebral artery ischemia are independent risk factors for delirium after aortic arch surgery.

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