非体外循环冠状动脉旁路移植术后再次气管插管的研究  

Risk Factors and Preventive Measures of Reintubation in Patients Undergoing Off-pump Coronary Artery Bypass Grafting

作　　者：胡晖[1] 顾承雄[1] 杨俊峰[1] 刘锐[1] 

机构地区：[1]首都医科大学附属北京安贞医院心脏外科,北京市100029

出　　处：《中国全科医学》2011年第2期156-158,共3页Chinese General Practice

摘　　要：目的探讨非体外循环冠状动脉旁路移植术(OPCABG)术后再次气管插管的原因,以便积极预防。方法回顾性分析我科室2006—2009年施行的2 321例OPCABG术后再次气管插管49例患者临床资料及预后。结果经再次气管插管后25例存活,24例死亡,病死率为49.0%。患者年龄、术前心功能、术前心胸比、陈旧性心肌梗死、术后术后主动脉内球囊反博辅助治疗率、肺部感染率、中心静脉压(CVP)>14 mm Hg、围术期心肌梗死发生率在再插管与非再插管组间差异均有统计学意义(P<0.05)。结论准确的病情评估、确切的再动脉化和术后积极的治疗措施可以有效地减少再插管的发生,有利于术后患者顺利恢复。Objective To explore the risk factors and preventive measures of reintubation in patients undergoing off-pump coronary artery bypass grafting（OPCABG）.Methods The clinical data and prognoses of 2,321 patients who had undergone OPCABG in our department from 2006 to 2009 were retrospectively analyzed.Results Of 49 patients who received reintubation,25 survived and 24 died,making a case-mortality rate of 49.0%.Significant differences existed between patients who received reintubation and those who did not receive reintubation in terms of age,preoperative heart function,preoperative cardiothoracic ratio,old myocardial infarction,application of intra-aortic balloon pump,pulmonary infections,a central venous pressure（CVP）14mmHg after OPCABG,and perioperative myocardial infarction（all P〈0.05）.Conclusion Many factors may be related with the reintubation.Accurate disease assessment,proper arterialization,and active postoperative management can effectively reduce the reintubation events and promote the recovery.

关 键 词：冠状动脉旁路移植术 非体外循环 插管法 气管内 

分 类 号：R654.2[医药卫生—外科学]