老年患者体外循环心脏手术后发生并发症的风险分析  

Analysis of risk factors for complications in elderly patients with cardiac surgery under cardiopulmonary bypass

作　　者：陈定柱[1] 张奕[1] 朱元佑[1] 刘进平[1] 沈斐敏[1] 

机构地区：[1]福建医科大学附属漳州市医院心胸外科,363000

出　　处：《中华老年医学杂志》2013年第4期386-389,共4页Chinese Journal of Geriatrics

摘　　要：目的分析老年患者体外循环下心脏外科围术期并发症及危险因素。方法我科自2004年7月至2012年6月共为64例年龄≥60岁的老年患者施行体外循环下心脏手术，通过收集患者相关临床资料，采用单因素及多因素Logistic回归方法分析老年患者体外循环下心脏外科围术期常见并发症及危险因素。结果本组患者术后并发症发生率34．4％（22／64），发生并发症例次42例次，早期手术死亡4例，手术死亡率6．3％。单因素分析显示，术前合并慢性阻塞性肺疾病（P=0．001）、术前合并糖尿病（P=0．009）、体外循环时间≥2h（P=0．000）、主动脉阻断时间≥90min（P=0．001）、输血量≥2000ml（P=0．000）是老年患者体外循环下心脏手术后出现并发症的危险因素。多因素Logistic回归分析示术前合并慢性阻塞性肺疾病（P=0．007）、术前合并糖尿病（P=0．028）、体外循环时间≥2h（P=0．003）、输血量≥2000ml（P=0．030）是老年患者体外循环下心脏手术后出现并发症的独立危险因素。结论术前合并慢性阻塞性肺疾病、糖尿病、体外循环时间≥2h。[Abstract] Objective To analyze the risk factors for complications in elderly patients with cardiac surgery under cardioputmonary bypass. Methods From July 2004 to June 2012,64 patients aged ≥ 60 years undergoing cardiac operations were selected. Clinical data were collected. The complications after cardiac operation and the risk factors were evaluated by single factor analysis and multivariate Logistic regression analysis with SPSS software. Results The postoperative complication rate in all patients was 34.4% （22/64）. The complications occurred in 42 subjects and operative mortality was 6.3% （4/64）. The single factor analysis showed that chronic obstructive pulmonary disease combined before operation （P= 0. 001）, diabetes combined before operation （P = 0. 009）, cardiopulmonary bypass time ≥2 h （P=0. 000）, aortic cross clamping time ≥90min （P= 0. 001）, and blood transfusion volume ≥2000 ml （P=0. 000） were the important risk factors for postoperative complications. Multivariate Logistic regression analysis revealed that chronic obstructive pulmonary disease （P = 0. 007） and diabetes combined before operation （P= 0. 028）, cardiopulmonary bypass time ≥2 h （P=0. 003）, and blood transfusion volume ≥2000 ml （P=0. 030） were the significant independent predictive risk factors for postoperative complications. Conclusions Chronic obstructive pulmonary disease, diabetes, cardiopulmonary bypass time ≥2 h, aortic cross clamping time≥90 rain, and blood transfusion volume ≥2000 ml are the independent predictive risk factors for postoperative complications in elderly patients with cardiac surgery under cardiopulmonary bypass.

关 键 词：心脏外科手术 体外循环 手术后并发症 危险因素 

分 类 号：R654.2[医药卫生—外科学]