首页|Stanford B型主动脉夹层术后谵妄209例危险因素分析及早期预防的回顾性队列研究

Stanford B型主动脉夹层术后谵妄209例危险因素分析及早期预防的回顾性队列研究

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目的 分析Stanford B型主动脉夹层患者术后谵妄发生的危险因素并探讨预防措施.方法 回顾性分析2020年1月-2021年8月于华中科技大学同济医学院附属同济医院心脏大血管外科诊断为Stanford B型主动脉夹层并行血管腔内修复术患者的临床资料.依据患者术后有无谵妄发作分为无谵妄组和谵妄组.分析Stanford B型主动脉夹层术后谵妄的危险因素和右美托咪定对谵妄的保护作用.结果 纳入659例患者,其中男540例、女119例,年龄58.00(41.00,75.00)岁.无谵妄组450例,谵妄组209例.两组患者性别、体重指数、高血压、高脂血症、吸烟和饮酒史、胆固醇、甘油三酯水平、肌酐、肾小球滤过率等术前资料差异无统计学意义(P>0.05).年龄是Stanford B型主动脉夹层术后谵妄发生的独立危险因素[OR=1.392,95%CI(1.008,1.923),P=0.044].右美托咪定使用与否对术后谵妄持续时间无影响(x2=4.662,P=0.588).结论 年龄是Stanford B型主动脉夹层患者术后谵妄发生的独立危险因素,青年患者的术后谵妄发生率较中老年患者低,对于指导术后谵妄预防有一定的参考价值.右美托咪定对于控制术后谵妄持续时间无明显作用.
Risk factors and preventive strategies of postoperative delirium in 209 patients with Stanford B aortic dissection:A retrospective cohort study
Objective To investigate the risk factors and prevention strategies of postoperative delirium in Stanford B aortic dissection.Methods Clinical data of the patients diagnosed with Stanford B aortic dissection and undergoing endovascular aortic repair from January 2020 to August 2021 in our department were retrospectively collected.Patients were divided into a non-delirium group and a delirium group according to the presence of postoperative delirium.The risk factors for postoperative delirium after Stanford type B aortic dissection and the protective effect of dexmedetomidine on delirium were analyzed.Results A total of 659 patients with Stanford type B aortic dissection were enrolled,including 540 males and 119 females with a median age of 58.00(41.00,75.00)years.There were 450 patients in the non-delirium group,and 209 patients in the delirium group.There was no statistical difference in gender,body mass index,hypertension,hyperlipidemia,smoking and drinking history,cholesterol triglyceride level,or creatinine glomerular filtration rate(P>0.05).Age was an independent risk factor for postoperative delirium in Stanford type B aortic dissection(OR=1.392,95%CI 1.008-1.923,P=0.044).Moreover,whether dexmedetomidine was used or not had no effect on the duration of postoperative delirium(x2=4.662,P=0.588).Conclusion Age is an independent risk factor for postoperative delirium in patients with Stanford type B aortic dissection.The incidence of postoperative delirium in young patients is lower than that in the patients with middle and elderly age,and it may be of reference value to prevent postoperative delirium.Dexmedetomidine has no significant effect on controlling the duration of postoperative delirium.

Stanford B aortic dissectionpostoperative deliriumrisk factordexmedetomidinetreatment

李娜、魏翔、冯鑫、陈司奇、陈太强

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华中科技大学同济医学院附属同济医院心脏大血管外科(武汉 430030)

Stanford B型主动脉夹层 术后谵妄 危险因素 右美托咪定 治疗

2024

中国胸心血管外科临床杂志
四川大学华西医院

中国胸心血管外科临床杂志

CSTPCD北大核心
影响因子:0.846
ISSN:1007-4848
年,卷(期):2024.31(5)
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