Analysis Of Risk Factors For Neurological Complications After Emergency Operation With Acute Type A Aortic Dissection

BackgroundAortic dissection(AD)is a critically vascular diseases that seriously affect the safety of human life.In recent years,with the improvement of medical staffs understanding of aortic large vessel disease,as well as the advancement of imaging department,cardiac and large vessel surgery,anesthesia and body circulation technology,the diagnosis rate of aortic dissection has continuously increased,surgical mortality and related complications have decreased significantly,but postoperative complications cannot be ignored.The most common one is neurological complications.Some studies have shown that neurological complications after acute aortic dissection are the main factors leading to hospital deaths.This study reviewed The preoperative data,intraoperative data,postoperative data and other factors of 51 patients were found to be the risk factors for neurological complications of postoperative patients,which are of great significance for the treatment effect and prognosis evaluation of patients with acute aortic dissection(type A).ObjectiveA retrospective statistical analysis of emergency surgical cases of patients with acute aortic dissection(Stanford Type A),and found related risk factors of neurological complications after emergency surgery;MethodsA retrospective randomized study method was used to select 51 patients with acute aortic dissection(Stanford type A)admitted between October 2018 and May 2019.The statistical and analytical information included age,gender,weight,smoking history,and history of hypertension、Preoperative white blood cells,preoperative platelets,preoperative hemoglobin concentration,preoperative lactate value,coagulation index,operation time,cardiopulmonary bypass transfer time,aortic occlusion time,cryopreservation time,tracheal intubation time,ICU hospitalization Related risk factors such as time,single-factor analysis of the related influencing factors of postoperative neurological dysfunction including permanent neurological deficits(PND)and transient neurological deficits(TND).PND refers to a patient with cerebral embolism or cerebral hemorrhage who has a positive result on the head MRI or head CT and is usually more difficult to recover.TND refers to a patients with transient symptoms such as confusion,irritability,depression,or lack of consciousness,but no significant positive results were found on the head MRI or head CT examination.Generally,it can recover in a short time.Univariate analysis screened relevant risk factors.If the P value was less than 0.1,the relevant factors were imported into Logistic regression analysis.P value of less than 0.05 was statistically significant.ResultsAge,preoperative D dimer,time for tracheal intubation and ICU hospital stay,preoperative coagulation factor activity R are related risk factors for postoperative TND(P<0.1);Dimer,tracheal intubation time and ICU hospitalization time were related risk factors for PND(P<0.1).Logistic regression analysis showed that the independent risk factor for PND is age.The independent risk factors for the occurrence of TND is preoperative coagulation factor activity R.ConclusionFor patients with acute pre-emergent acute aortic dissection who are older(over 62.6-64.5 years old),with reduced coagulation factor R(less than 4.0),it is recommended to taken more active brain protection measures to reduce the occurrence of postoperative neurological complications in patients with acute aortic dissection,further improve the quality of life.