21例肺动脉血栓内膜剥脱术预后影响因素分析

目的:肺动脉血栓内膜剥脱术(PTE),对于慢性肺动脉栓塞患者是一种有效的治疗方法。本文拟通过对施行PTE患者围手术期预后影响因素进行分析,以期通过围术期临床常见检测手段来为此类患者提供预后判断。方法:择期21例患者单纯施行PTE术,记录ICU入住天数为因变量,以患者年龄(AGE),病程(Course,year),体外循环的时间(TCPB)和ASA分级,术前平均肺动脉压(mPAPPRE),术前右心室/左心室容积比(RV/LVPRE),术后右心室/左心室容积比(RV/LVPOST),术前左心室射血分数(LVEFPRE)和术后左心室射血分数(LVEFPOST)为自变量;采用多因素线性回归分析模型评价各影响因素的作用大小。结果:施行PTE患者的围手术期预后影响因素包括ASA分级、mPAPPRE、RV/LVPRE、TCPB和LVEFPOST。结论:本研究提示在PTE手术的临床监测指标中,患者的一般状况(ASA分级)、术前平均肺动脉压、术前右心室/左心室容积比、体外循环时间和术后LVEFPOST与预后转归密切相关。

Predictors of perioperative outcomes after pulmonary thromboendarterectomy in Chinese

Objective:Pulmonary thromboendarterectomy(PTE) is an effective treatment option for patients with chronic thromboembolic pulmonary hypertension.Objectives:To analyze the correlation between the general perioperative characteristics and the prognosis after operation,and to offer a prognosis prediction for clinic.Methods:21 Chinese patients scheduled for elective PTE surgery were included in the study.Patients with history of hypertension,cerebral diseases and endocrine system diseases were excluded.Duration of intensive care unit was recorded for determination of perioperative outcomes.The component of cases included AGE,Course,duration of CPB(TCPB),ASA scale,mPAPpre before operation,RV/LV and LVEF before operation,RV/LV and LVEF after operation.The multivariate liner regress analysis model was used to evaluate the influence of the variables.Results:Multivariate liner regress analysis showed that Duration of intensive care unit after PTE surgery was related with the ASA,mPAPpre,RV/LVPRE,TCPB and LVEFPOST.Conclusion:This study shows the ASA,mPAP,RV/LVPRE,TCPB and LVEFPOST are predominant influences of perioperative outcomes for PTE surgery.