Investigation Of Life Quality And Influencing Factors In Patients With Stanford Type A Aortic Dissection

ObjectiveThe purpose of this study is to investigate the quality of life and related factors in patients with Stanford A type aortic dissection,and find out the independent risk factors related to the quality of life after Stanford A type aortic dissection,and provide evidence-based medical basis for the prevention and treatment of patients with poor quality of life after operation,and finally improve the quality of life of patients with Stanford a aortic dissection.MethodIn this study,patients with Stanford A type aortic dissection were selected from Department of cardiovascular surgery,Some Grade a Class-three Hospital in Changchun city.All patients underwent aortic dissection surgery and had complete follow-up information.The general basic data(age,gender,family income,family history,etc.)and quality of life(SF-36)were collected and analyzed statistically.The database of patients was established,and the postoperative status and quality of life after discharge were summarized and sorted out.SPSS 22.0 was used The data analysis includes single factor variance analysis,multi factor Logistic regression analysis and correlation analysis.Result(1)The mean SF-36 score of 110 patients with Stanford A type aortic dissection was 72.4 ± 8.67,the highest score was 91 and the lowest score was 52.The eight dimensions of SF36 were physiological function score 80.2 ± 5.4,social function score 75.5 ± 9.2,emotional function score 65.5 ± 12.2,physical pain score 72.8 ± 9.4,postoperative general condition score 57.4 ± 8.8,energy score 59.8 ± 6.7,physiological function score 56.3 ± 12.5 and mental health score 67.2 ± 14.3.(2)Among the 110 patients who received quality of life assessment,statistical analysis of the postoperative population distribution of Stanford A aortic dissection patients showed that 60 patients(54.5%)aged 40-60 years old accounted for the largest proportion.72(65.5%)of the working patients accounted for the largest proportion.99 people(90.0%)were married.65 people(59.1%)with a monthly income of more than 4000 yuan accounted for the largest proportion.Among them,65 had high school education,accounting for the largest proportion(59.1%).In the proportion of medical insurance payment,there were 97 medical insurance personnel(88.2%)and 13 self funded patients(11.8%).104 patients(94.5%)had no family history.67 patients(60.9%)had good sleep.61 patients(55.5%)had good medication compliance.(3)According to the 60 score standard,the number of SF-36 failing was 42,the positive rate was 38.2%.Sleep status and medication compliance were taken as independent variables,and low quality of life as dependent variables.The results showed that the risk rate of poor sleep state and low quality of life was 2.318 times higher than that of good sleep state,and the risk rate of poor medication compliance and low quality of life was 3.041 times higher than that of good medication compliance.Therefore,poor sleep status and poor medication compliance are the risk factors of poor quality of life in patients with Stanford A aortic dissection.(4)All 110 patients were followed up after discharge.61 patients with good compliance with medication,45 of them had high quality of life and 16 had low quality of life.49 patients with poor compliance with medication,23 had high quality of life and 26 were poor in quality of life,and There was significant correlation between the two groups(P < 0.05).There were significant differences between the patients with poor compliance with medication(P < 0.05).(5)The correlation analysis of drug compliance and sleep quality was conducted in 110 patients.61 patients with good compliance were given medication,of which 56 patients had high sleep quality and 5 had low sleep quality.49 patients with poor compliance were given medication,including 11 patients with high sleep quality and38 cases with low sleep quality.The correlation coefficient between the two groups r= 0.761,indicating a high correlation.ConclusionThe patients with Stanford A type aortic dissection had poor quality of life;sleep quality and Medication compliance were independent risk factor for the quality of life;there were significant differences between patients with good compliance with medication and poor compliance.There was a high correlation between drug compliance and sleep quality.