导致冠状动脉旁路移植术后低氧血症的原因分析  

Analysis of causes of postoperative hypoxemia in patients undergoing coronary artery bypass grafting

作　　者：邱宗利 

机构地区：[1]南阳医专第一附属医院心脏外科,河南省南阳市473058

出　　处：《中国心血管病研究》2014年第7期616-618,共3页Chinese Journal of Cardiovascular Research

摘　　要：目的 总结冠状动脉旁路移植术后出现低氧血症的相关原因,探讨防治措施.方法 选取我院2008-2013年于心外科行冠状动脉旁路移植术（CABG）的100例患者,对其手术资料进行分析.低氧血症的诊断标准为：排除贫血等因素导致的氧分压降低情况后,在机械通气（FiO2＞45％）或面罩联合鼻导管吸氧（氧流量6 L/min）的情况下供氧,冠状动脉旁路移植术后患者的氧分压仍低于[102-（0.33×年龄）mmHg]的患者.结果 100例冠状动脉旁路移植术患者,术后共有30例出现不同程度的低氧血症症状,发生率为30％（30/100）.随着年龄的增大术后低氧血症的发生率不断升高.低氧血症多在术后第1天出现,急诊手术、有吸烟史,以及合并高血压、糖尿病、心梗、肺部疾病是低氧血症发病的危险因素（P＜0.05）.结论 对冠状动脉旁路移植术后的低氧血症要做好充分的预防,发现后及时纠正,可提高手术治疗的效果.Objective To summarize the relevant causes of postoperative hypoxemia in patients undergoing coronary artery bypass grafting （CABG） and investigate the effective preventive treatment measures.Methods The operation material of one hundred patients who received CABG in our hospital from 2008 to 2013 was analyzed.Except that the oxygen tension was lowered by factors like anemia,mechanical ventilation （FiO2 over 45％）or mask oxygen supply （over 6 L/min） was administrated following CABG,PaO2 less than [102-（0.33×age）mm Hg] was diagnosed as postoperative hypoxemia.Results Postoperative hypoxemia occurred in 30 patients out of the 100 patients who received CABG （incidence rate 30％）.The incidence rate of postoperative hypoxemia increased gradually with the increase of patients＇ age.Most of the postoperative hypoxemia occurred in the first day after operation.The risk factors that caused postoperative hypoxemia were emergency operation,smoking history,combined hypertension,acute myocardial infarction and pulmonary disease （P＜0.05）.Conclusion Preventing the incidence of hypoxemia and correcting the hypoxemia timely can enhance the effects of CABG.

关 键 词：冠状动脉旁路移植术 低氧血症 影响因素 防治措施 

分 类 号：R654.2[医药卫生—外科学]