冠脉搭桥术后呼吸机辅助时间的影响因素分析  

Analysis of factors related to the length of mechanical ventilation after coronary artery bypass grafting

作　　者：杨荣利[1] 洪秀琴[1] 赵睿[1] 

机构地区：[1]辽宁省大连市中心医院ICU,116033

出　　处：《辽宁医学杂志》2007年第2期59-61,共3页Medical Journal of Liaoning

摘　　要：目的分析冠脉搭桥心脏手术后患者呼吸机辅助时间的影响因素，探讨如何减少冠脉搭桥术后机械通气时间。方法回顾分析我院在2002年1月至2005年8月期间122例冠脉搭桥手术后转入ICU患者的临床资料，对这些患者的呼吸机辅助时间、术前左心射血分数（LVEF）、体外循环时间、输血量、术后引流量、术后并发症及入ICU时的氧合指数、红细胞压积和白蛋白水平等指标进行多元线性回归分析，并评价各影响因素的作用大小。结果本组患者术后呼吸机辅助时间为29．23（4—264）小时，病死率为6．56％（8／122）。多因素线性回归分析结果显示．决定术后机械通气时间的主要影响因素依次为患者术后并发症（P〈0．01）、术中及术后总输血量（P〈0．05）及术中体外循环时间（P〈0．05）。结论采取措施防治冠脉搭桥术后并发症、减少围术期输血量及体外循环时间可缩短术后机械通气时间，从而改善患者预后。Objective To analyze the factors that related to the length of mechanical ventilation after coronary artery bypass grafting （ CABG）, and to discuss how to improve them, Methods 122 patients eared in ICU after CABG from January 2001 to August 2005 were retrospectively analyzed. Multivariate linear regression were employed to analyze the relevant factors including preoperative left ventrieular ejection fraction, length of eardiopulmonary bypass, volume of blood transfused, postoperative drainage, complications and the oxygenation index, hematocfit, and albumin on the arrival at ICU. Results The mean mechanical ventilation time was 29.23 （4 - 264） hours. The mortality was 6.56% （8/122）. Multivariate linear regress analysis revealed that the main factors correlated with the length of mechanical ventilation included postoperative complications （ P 〈0. 01 ）, volume of blood transfused （ P 〈0.05 ） and length of eardiopulmonary bypass （ P 〈0.05 ）. Condusion Measures that decrease the postoperative complications, perioperative blood transfusion and length of eardiopulmonary bypass can reduce the length of mechanical ventilation after CABG.

关 键 词：冠脉搭桥 呼吸机 多因素分析 ICU 

分 类 号：R654.2[医药卫生—外科学]