关键词: 肥胖, A型主动脉夹层, 围术期并发症

Abstract: Objective  To investigate the effect of obesity on perioperative complications in patients with acute Stanford A aortic dissection(TAAD).  Methods   According to BMI,the patients were divided into obese group (BMI ≥28kg/m²) and non-obese group (BMI < 28kg/m²) .The obese group included 55 cases,the non-obese group included 78 cases,133 cases in total.The differences of postoperative hypoxemia, ventilator assistance time, pulmonary infection, nervous system complications, acute kidney injury, poor wound healing, blood transfusion volume, hospital mortality and length of stay were compared between the two groups.  Results   The proportion of hypoxemia,extubation time ≥96 hours,poor wound healing,CSICU(Cardiac Surgery Intensive Care Unit) ≥7 days and total hospital stay ≥20 days in obese group were significantly higher than those in non-obese group (P＜0.05),there was no significant difference in postoperative acute renal injury,pulmonary infection,neurological complications and in-hospital mortality between the two groups(P>0.05).BMI≥28km²,extubation time ≥96h,and pulmonary infection were the main independent risk factors for hospital stay ≥7 days in CSICU after Type A aortic dissection.Patients with BMI ≥28kg/m² had 2.45 times more CSICU hospital days (≥7 days) than non-obese patients.  Conclusion   Obesity increases the incidence of perioperative complications in patients with acute Stanford A aortic dissection and is an independent risk factor for hospital stay of ≥7 days in CSICU,but there is no significant difference in in-hospital mortality.

Key words: obesity, Stanford A aortic dissection, perioperative complication