[1]付超 杨志浩 尤阳 刘子华 黄中旭 赵鑫.基于预后营养指数评价裸缝法对孙氏手术患者的影响[J].心血管病学进展,2025,(7):646.[doi:10.16806/j.cnki.issn.1004-3934.2025.07.015]
　FU Chao,YANG Zhihao,YOU Yang,et al.Evaluation of the Effect of B are Suture Method on Patients Undergoing Sun ’s Surgery Based on Prognostic Nutritional Index[J].Advances in Cardiovascular Diseases,2025,(7):646.[doi:10.16806/j.cnki.issn.1004-3934.2025.07.015]
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基于预后营养指数评价裸缝法对孙氏手术患者的影响()

《心血管病学进展》[ISSN:51-1187/R/CN:1004-3934]

卷:
期数:
2025年7期
页码:
646
栏目:
论著
出版日期:
2025-07-25

文章信息/Info

Title:
Evaluation of the Effect of B are Suture Method on Patients Undergoing Sun ’s Surgery Based on Prognostic Nutritional Index
作者:
付超 杨志浩 尤阳 刘子华 黄中旭 赵鑫
(山东大学齐鲁医院心血管外科,山东 济南 250012)
Author(s):
FU Chao;  YANG Zhihao;  YOU Yang;  LIU Zihua;  HUANG Zhongxu;  ZHAO Xin
(Department of Cardiovascular Surgery,Qilu Hospital of Shandong University,Jinan 250012,Shandong,China)
关键词:
主动脉夹层; 主动脉弓置换术; 循环停止; 心房分流; 孙氏手术
Keywords:
Aortic dissection;  A ortic arch replacement;  Circulatory arrest;  Atrial shunt;  Sun ’s Surgery
DOI:
10.16806/j.cnki.issn.1004-3934.2025.07.015
摘要:
目的 基于患者围手术期预后营养指数（PNI）来评估急性A型主动脉夹层（AAAD）手术中行裸缝法的近中期手术效果。方法 收集2017年12月—2022年12月在山东大学齐鲁医院接受孙氏手术的249例患者的临床资料进行回顾性分析。根据手术中是否使用裸缝法，患者被分为裸缝组（n=108）和分流组（n=141）。比较两组围手术期PNI变化、30天死亡率等指标。随访获得患者近中期死亡率。结果 与分流组相比，裸缝组的主动脉阻断时间（P＜0.001）和循环停止时间（P＜0.001）较长，但手术总时间相似（P＞0.05）。分流组术后重症监护时间较裸缝组更长（P＜0.001）。围手术期PNI变化两组之间差异显著（P=0.014），裸缝组对患者围手术期营养状况的影响较小。随访结果显示，两组近期死亡率相似，30 d 、3个月、6个月和12个月死亡率均无显著差异（P分别为0.651、0.623、0.471和0.471），但分流组术后发生急性心力衰竭的可能性更高（P=0.020）。结论 在AAAD患者中，采用裸缝技术对患者PNI的影响更小，可能更有利于术后的预后，在技术成熟情况下可作为一种优先考虑的手术方式。
Abstract:
Objective To evaluate the short- and mid-term outcomes of bare suture method in acute type A aortic dissection (AAAD) surgery based on perioperative PNI. Methods The clinical data of 249 patients who underwent Sun’s surgery at Qilu Hospital of Shandong University from December 2017 to December 2022 were collected for retrospective ananlysis . The patients were divided into bare suture group (n=108) and shunt group (n=141) based on whether bare suture method was used during the operation. The perioperative PNI changes and 30-day mortality were compared between the two groups. The short-term and mid-term mortality of patients were followed up. Results Compared with the shunt group,the aortic clamping time (P＜0.001) and circulatory arrest time (P＜0.001) were longer in the bare suture group,but the total operation time was similar (P＞0.05). The postoperative intensive care time in the shunt group was longer than in the bare suture group (P＜0.001). There was a significant difference in perioperative PNI between the two groups (P=0.014),and the bare suture group had little effect on the perioperative nutritional status of patients. The follow-up results showed that the short-term mortality was similar between the two groups,and there was no significant difference in 30-day,3-month,6-month and 12-month mortality (P=0.651,0.623,0.471,0.471),but the shunt group was more likely to have acute heart failure postoperatively (P=0.020). Conclusion In AAAD patients,the use of bare suture technology has less impact on PNI,which may be more conducive to postoperative prognosis. It can be used as a preferred surgical method when the technology is mature

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