80岁以上高龄患者行冠状动脉旁路移植术危险因素分析  

A Comparative Study of Risk Factors for Octogenarian Patients Undergoing Coronary Artery Bypass Grafting

作　　者：李洪利[1] 徐东[1] 尚学斌[1] 刘燕辉[1] 刘飞[1] 张科峰[1] 姚青[1] 

机构地区：[1]首都医科大学宣武医院心脏科,北京100053

出　　处：《中国医刊》2012年第10期49-51,共3页Chinese Journal of Medicine

摘　　要：目的对比研究80岁以上高龄患者行冠状动脉旁路移植术(CABG)的潜在危险因素、术后主要并发症及死亡率。方法回顾性分析2002年1月1日至2012年1月31日本院心脏外科行CABG的超过80岁高龄患者资料41例(A组);SinoSCORE评分大于6分的65～79岁老年患者资料57例(B组)。对两组潜在危险因素及术后主要并发症进行对比研究。结果 A组男32例,女9例,手术时平均年龄(82.12±1.08)岁;B组男38例,女19例,手术时平均年龄(73.43±2.58)岁。统计分析结果显示,A组较B组二尖瓣反流例数、EF值、术前最后1次肌酐值、术前最后1次血糖值、术前使用正性肌力药物病例数差异有显著。术后呼吸机使用时间,重症监护时间,二次开胸止血例数三项指标在两组间差异有显著。但在急性心肌梗死病例数上A组却明显少于B组(P<0.01)。结论与一般老年患者相比,在SinoSCORE模型评分无差异的情况下,80岁以上CABG患者可能存在更多的危险因素,且术后主要并发症的发生率及死亡率均显著增高。Objective To identify the pre-operative risk factors and post-operative major complications in patients elder than 80 years who underwent coronary artery bypass grafting（CABG）. Methods We retrospectively analyzed tile information of 41 patients （group A） at the mean age of（ 82.12±1.08 ）years who underwent CABG from January 2002 to January 2012 in our hospital, and selected another 57 patients （group B） at the mean age of（73.43±2.58） years who underwent the same procedures during the same period. The pre-operative risk factors and post-operative major complications were studied and compared in both groups. Results The female patients were 22% （9/41）in group A and 33% （19/57）in group B. Compared with group B ,in group A, more patients suffered from mitral regur- gitation,they also showed increased blood creatinine and glucose （P〈0.05 respectively）, decreased left ventricular ejection fraction before the operation. While after the operation, group A had more incidence of extended ICU time, post-operative respiratory failure and secondary thoracotomy ibr bleeding（ P〈0.05 respectively）. Conclusion With the same scoring of SinoSCORE, patients more than 80 years old had more potential risks for CABG before the oper- ation, they usually needed extended ICU time after the operation and had more chance to suffer from the major post- operative complications and mortality.

关 键 词：高龄患者 冠状动脉旁路移植术 危险因素 并发症 

分 类 号：R653[医药卫生—外科学]