3D打印支架开窗术胸腹主动脉夹层患者营养状况及影响因素分析,Journal of Cardiothoracic Surgery

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3D打印支架开窗术胸腹主动脉夹层患者营养状况及影响因素分析
Journal of Cardiothoracic Surgery ( IF 1.5 ) Pub Date : 2023-03-21 , DOI: 10.1186/s13019-023-02185-6
Yan Zhou ₁ , Ying Xu ₁ , Ying Cai ₁

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调查3D打印辅助覆膜支架开窗治疗主动脉夹层（AD）患者的营养状况，探讨影响不同开窗（孔）数患者营养状况的重要因素。选择2020年1月至2020年12月在南京市某三级甲等医院住院的99例AD患者作为研究对象。根据开窗数目不同将患者分为4组：1开窗（A组）、2开窗（B组）、3开窗（C组）和4开窗（D组）；并对四组患者的营养状况进行分析。然后根据输液提供的热量是否达到术后第5天的80%目标热量（25kcal/kg/天），将患者分为Reached组和Not reached组，分析术后第1天和第5天的炎症指标，包括白细胞（WBC）和C反应蛋白（CRP）。与B组（18.8%）、C组（19.4%）和D组（6.7%）患者相比，A组患者（48.6%）的营养需求（80%目标热量）达到率最高。此外，在 Reached 组中，与术后第 1 天相比，术后第 5 天的 WBC 计数和 CRP 浓度显着降低，并且 WBC 计数异常的患者比例显着降低。相反，虽然Not reached组术后第5天的CRP浓度明显低于术后第1天，但未观察到WBC计数的显着变化。在 AD 的 3D 打印辅助覆膜支架开窗中，多个开窗（孔）与营养需求的低达到率相关，这可能与炎症有关。因此，术后应给予多开窗患者有效的营养支持，以改善其营养状况和预后。

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Analysis of nutritional status and influencing factors in patients with thoracoabdominal aortic dissection receiving 3D printing-assisted stent graft fenestration

To investigate the nutritional status of patients with aortic dissection (AD) treated with using 3D printing-assisted stent graft fenestration and explore the important factors affecting the nutrition status of patients with different numbers of fenestrations (holes). Ninety-nine hospitalized patients with AD in a grade A tertiary hospital in Nanjing from January 2020 to December 2020 were selected as the study subjects. According to the different number of fenestrations, the patients were divided into four groups: one fenestration (group A), two fenestrations (group B), three fenestrations (group C) and four fenestrations (group D); and the nutrition status of patients in the four groups was analyzed. Then, according to whether the calories provided via infusion reached the 80% goal calories (25 kcal/kg/day) on postoperative day 5, the patients were assigned to the Reached group and Not reached group, and their inflammatory parameters, including white blood cell (WBC) and C-reactive protein (CRP), on postoperative days 1 and 5 were analyzed. Compared with patients in group B (18.8%), C (19.4%) and D (6.7%), patients in group A (48.6%) had the highest rate of reaching the nutrition requirement (80% goal calories). Further, in the Reached group, WBC count and CRP concentration were significantly reduced on postoperative day 5 compared with postoperative day 1, and the proportion of patients with abnormal WBC count was significantly decreased. In contrast, although the CRP concentration on postoperative day 5 in the Not reached group was significantly lower than that on postoperative day 1, no significant changes in WBC count were observed. In 3D printing-assisted stent graft fenestration for AD, multiple fenestrations (holes) were associated with a low rate of reaching nutrition requirements, which might be related to imflammation. Therefore, effective nutritional support should be given to patients with multiple fenestrations after operation to improve their nutritional status and prognosis.

更新日期：2023-03-21

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