冠状动脉旁路移植术患者术前相关因素与术后并发症相关性分析  

Correlation Analysis Between the Related Factors before Anesthesia and Postoperative Complications in Patients with CABG Surgery

作　　者：易莉莎[1] 黄梦玉[1] 王婷婷 石琴芳 郭超 武庆平[1] 陈向东 姚尚龙[1] Yi Lisha;Huang Mengyu;Wang Tingting(Union Hospital,Tongji Medical College of Huazhong University of Science and Technology, Hubei 430022,China)

机构地区：[1]华中科技大学同济医学院附属协和医院麻醉科,武汉430022 [2]华中科技大学同济医学院附属协和医院心外科,武汉430022

出　　处：《医学研究杂志》2018年第12期162-165,共4页Journal of Medical Research

摘　　要：目的探讨冠状动脉旁路移植术(coronary artery by pass grafting,简称CABG手术)患者术前相关因素与术后并发症的关系。方法按照预设的纳入标准,入选2011年6月～2013年6月于华中科技大学同济医学院附属协和医院行CABG治疗的患者416例,收集患者术前的相关临床资料,统计患者术后并发症,并通过病历资料、门诊、住院或电话随访至2014年7月30日。通过Logistic回归分析CABG患者发生全因死亡的相关危险因素。结果 416例患者,住院期间3例死亡,其他并发症74例。Logistic回归分析表明高龄(OR=1. 17,95%CI:1.06～1.42,P=0. 034)、糖尿病(OR=1.56,95%CI:1.21～2. 08,P=0. 009)、心肌梗死(OR=4. 52,95%CI:2. 65～7. 39,P=0.000)、心功能Ⅲ级或Ⅳ级(OR=1.22,95%CI:1. 17～1.40,P=0.000)、LVEF<40%(OR=2.34,95%CI:1.53～3.58,P=0.028)是患者发生术后并发症的独立危险因素。平均随访时间2. 1年,共有48例患者发生了联合终点事件,Logistic回归分析表明,高龄(OR=1.26,95%CI:1. 17～1.51,P=0.029)、糖尿病(OR=1.37,95%CI:1.12～1. 76,P=0.012)、不稳定型心绞痛(OR=1.53,95%CI:1.39～2.68,P=0. 011)、心肌梗死(OR=3. 48,95%CI:1.64～5. 09,P=0.000)、心功能Ⅲ级或Ⅳ级(OR=1.22,95%CI:1. 03～1.78,P=0. 026)、LVEF <40%(OR=1.82,95%CI:1.25～2. 72,P=0.000)和术后并发症(OR=2. 56,95%CI:1. 92～3. 59,P=0.000)均是患者发生联合终点事件的独立危险因素。结论高龄、糖尿病、心肌梗死、心功能Ⅲ级或Ⅳ级、LVEF<40%是患者发生术后并发症的独立危险因素,高龄、糖尿病、不稳定型心绞痛、心肌梗死、心功能Ⅲ级或Ⅳ级、LVEF <40%和术后并发症均是患者发生联合终点事件的独立危险因素。Objective To explore correlation analysis between the related factors before anesthesia and postoperative complications in patients with coronary artery bypass grafting (CABG)surgery.Methods According to the inclusive criteria setted before the research, we gathered relevant clinical datas of 416 patients with CABG in Wuhan Union Hospital from June 2011 to June 2013 before operation, counted complication postoperation,followe up until July 30th2014 through medical record,outpatient service,hospitalization,and telephone.The relevant risk factors that CABG patients occurred all-cause death were analysised with Logistic regression.Results 3 patients died,and 74 patients were attacked by other complication.Logistic regression indicated that elder patients (OR =1.17,95%CI. 1.06-1.42,P=0.034),diabetes mellitus(OR=1.56,95%CI.1.21-2.08,P=0.009),myocardiacinfarction (OR=4.52,95%CI: 2.65-7.39,P<0.001),heart function up Ⅲ level(OR=1.22,95%CI:1.17-1.40,P=0.000),and LVEF<40%(OR=2.34, 95%CI:1.53 -3.58,P =0.028)are independent risk factors that CABG patients occurred complication after operation.Follow-up 2.1 years averagely,48 patients occurred combined end point events.Logistic regression indicates that elder patients(OR =1.26,95%CI: 1.17-1.51,P=0.029),diabetes mellitus(OR=1.37,95%CI.1.12-1.76,P=0.012),unstable angina(OR=1.53,95%CI-1.39 -2.68,P =0.011 ),myocardiac infarction (OR =3.48,95 %CI:1.64 -5.09,P <0.000 ),heart function up III level (OR =1.22, 95%CI.1.03 -1.78 ,P =0.026),LVEF <40%(OR =1.82,95%CI:1.25 -2.72 ,P =0.000)and postoperative complications(OR = 2.56,95%CI:1.92 -3.59,P =0.000)were independent risk factors that CABG patients occurred combined end point events. Conclusion Older age,diabetes,myocardial infarction,cardiac function classification≥Ⅲ grade,LVEF <40%were independent risk factors for patients with complications after operation.Older age,diabetes,unstable angina,myocardial infarction,cardiac function classification≥Ⅲgrade,LVEF <40% and postoperative complications were all independent risk facto

关 键 词：冠心病 麻醉 冠状动脉移植术 并发症 危险因素 

分 类 号：R654.2[医药卫生—外科学]