冠状动脉旁路移植术后低心排的危险因素  

Analytical study of postoperative low cardiac output syndrome after coronary artery bypass grafting

作　　者：伍育旗[1] 余旻[1] 刘玉英 于超[1] 钱民[1] 王鹏[1] 谭崇俊 

机构地区：[1]三峡大学人民医院宜昌市第一人民医院重症医学科心内科,湖北宜昌443002 [2]宜昌市民富医院心内科,湖北宜昌443002 [3]长阳县人民医院重症医学科,湖北长阳443000

出　　处：《心脏杂志》2014年第3期320-322,共3页Chinese Heart Journal

摘　　要：目的:探讨冠状动脉旁路移植(CABG)术后低心排的危险因素。方法:采用病例对照研究,以宜昌市第一人民医院重症医学科2008年1月～2012年9月CABG术后临床资料完整的全部病例(92例)患者为研究对象,低心排[诊断标准:多巴胺用量>10μg/(kg·min)]者为病例组(n=13),以无低心排患者对照组(n=79)。对两组患者潜在的危险因素进行对比分析,并采用非条件logistic多元回归分析判断影响CABG术后低心排的独立危险因素。结果:单因素分析结果显示:年龄、性别、术前近期心肌梗死(MI)、心律失常、术后呼吸衰竭、术前贫血为CABG术后低心排的危险因素。logistic多因素回归分析显示,CABG术后低心排的独立的危险因素是:术前近期MI OR18.149,95.0%CI[1.949-169.011];心律失常OR 30.509,95.0%CI[2.607-357.028];女性OR 10.743,95.0%CI[1.347-85.659](P<0.05,P<0.01)。结论:术前近期MI;心律失常是CABG术后低心排的独立的危险因素。AIM Tocoronary artery bypassexplore the risk factors of postoperative lowcardiac output syndrome （LCOS） aftergrafting （CABG） in the intensive care unit （ICU）. METHODS： Data of 92 pa-tients undergoing cardiac vavular surgery from January 2008 to January 2013 in the Department of CriticalMedicine of the First People＇s Hospital in Yichang were retrospectively analyzed. Patients with postoperative LCOS [ dopamine 〉 10 μg/（ kg. min） ] were assigned to observation group and patients without postoperative LCOS severed as controls. Potential risk factors in the two groups were compared and multivariate nonconditional logistic regression analysis was conducted to determine the independent risk factorsresulting in LCOS after CABG. RESULTS： Of the 92 patients, 13 （14. 13% ） had postoperative LCOSafter CABG and univariate analysis showed that the risk factors for postoperative LCOS following CABGwere age, myocardial infarction, cardiac arrhythmia and female gender. Independent risk factors for postoperative LCOS after CABG were preoperative myocardial infarction （OR 18. 149, 95% CI 1. 949 to169. 011）, cardiac arrhythmia （ OR 30. 509, 95% CI 2. 607 to 357.028） and female gender （ OR10. 743, 95% C11. 347 to 85.659） （P 〈0. 05, P 〈0. 01）. CONCLUSION： Independent risk factorsfor LCOS following CABG are preoperative myocardial infarction and cardiac arrhythmia. Monitoring theserisk factors improves LCOS following CABG.

关 键 词：冠状动脉旁路移植术 低心排 病例对照研究 

分 类 号：R181.32[医药卫生—流行病学]