Clinical Analysis Of The Results Of 51 Cases Of Stanford Type A Aortic Dissection Postoperative

ObjectiveTo learn about the risk factors of Stanford type A aortic dissection (AD), explore the related influence factors of mortality postoperatively in patients with type A aortic dissection.MethodsA retrospective analysis of 51 patients with Stanford type A aortic dissection between January 2015 and March 2015 in cardiac surgery of the The second affiliated hospital of Zhengzhou university. All patients were taken surgical treatment. According to the Stanford classification method, the AD can be divided into:type A (lesions involving the ascending aorta); Type B (lesions not involving the ascending aorta). Collect and analyze selected patients gender, age, medical history, personal history, operation method, aorta blocking time, anesthesia time, ICU time and treatment results of clinical data. Measurement data using mean+/-standard deviation, said application SPSS17.0 statistical software for statistical analysis, P<0.05 was statistically significant.Results1, Hypertension is the main risk factors of patients with type A dissection, 72.5% of type A dissection patients who suffer from hypertension disease; 51 patients with Stanford type A, the average age (48.82+11.65),71.7%of the patients with onset age< 60 years old, so the patients'age(58.63 ± 12.45) tend to be younger compared with abroad (P<0.05). Type A dissection in men, men and women ratio of 5.4:1. Smoking, drinking these bad habits also with the more common and type A dissection, is leading to high incidence of type A dissection in risk factors, proportion of 56.9%,37.3% respectively; Hyperlipidemia, atherosclerosis, and aneurysm, marfan syndrome, pregnancy is not common in type A aortic dissection, such as the proportion were 3.9%,15.7%,13.7%,5.9%,2.0%.2,51 patients with aorta blocking time is (126.27±29.8) min, anesthesia time is (9.46±1.5) h, ICU endotracheal intubation time, ICU time, length of hospital stay, respectively (113.89±168.23)h, (8.65±8.09)d, (27.48±14.93)d, shows that type A AD time-consuming operation, the risk is big,and high demands on postoperative nursing care.3, Among the 51 cases with type A dissection,there are "aortic root replacement +total arch replacement+trunk stent implantation" 31 cases, "all the aortic arch replacement+trunk stenting" 13 cases,6 cases aortic root replacement,1 case "total chest aorta replacement". The are 10 patients death after surgical intervention and postoperative, total mortality was 19.6%. In the "aortic root replacement+total arch replacement+trunk stent implantation "in patients with postoperative nine deaths, mortality was 17.6%(9/51), including 5 cases died of multiple organ failure,3 cases died of severe pulmonary infection,1 case died of a stroke; Line "aortic arch replacement+trunk stenting in patients with 1 case died of multiple organ failure, mortality rate 2.0%(1/51).Conclusions1,Hypertension is the main risk factor for type A dissection,followed by smoking, drinking alcohol, so the control of blood pressure and improve personal habits and customs, there are likely to prevent type A dissection. Type A dissection in the majority with male patients, the onset age lower than abroad.2,Multiple organ failure is a major cause of mortality postoperatively in patients with type A dissection, followed by pulmonary infection, so meet each organ perfusion of type A dissection postoperation, improve the function of each organ, the prevention and treatment of infection at the same time, is the key to reduce the postoperative mortality type A dissection.