体外循环心脏手术术后并发症的影响因素研究  

Risk factors of postoperative complications in cardiac surgery under cardiopulmonary bypass

作　　者：黄小龙[1] 吴西林[1] 宋之昭[1] 

机构地区：[1]广西柳州医学高等专科学校第一附属医院心胸外科,广西柳州545000

出　　处：《检验医学与临床》2014年第17期2389-2391,共3页Laboratory Medicine and Clinic

摘　　要：目的探讨体外循环心脏手术术后并发症的影响因素。方法回顾性分析2009年5月至2013年3月行体外循环心脏手术的203例成年患者的临床资料,分析术后并发症发生情况;根据是否发生术后并发症,将患者分为并发症组和无并发症组,对可能的危险因素进行单因素分析和Logistic多因素回归分析。结果 203例患者中,发生术后并发症31例,并发症发生率为15.3%。单因素分析结果显示,年龄大于或等于55岁、体外循环时间大于或等于2h、主动脉阻断时间大于或等于100min、心脏功能Ⅳ级以及术前合并原发性高血压、糖尿病、慢性阻塞性肺疾病是诱发术后并发症的相关因素(P<0.05)。Logistic多因素回归分析结果显示,年龄大于或等于55岁、体外循环时间大于或等于2h、主动脉阻断时间大于或等于100min及心脏功能Ⅳ级是导致术后并发症的危险因素(P<0.05)。结论对于行体外循环心脏手术的患者,应通过术前评估,及时干预可诱发术后并发症的危险因素,从而提高手术安全性和疗效。Objective To investigate risk factors of postoperative complications in cardiac surgery under car-diopulmonary bypass .Methods A total of 203 adult patients undergoing cardiac surgery during May 2009 and March 2013 were enrolled and divided into complication group and non-complication group ,according to the incidence of postoperative complications .Then ,risk factors of postoperative complications were analyzed by using univariate anal-ysis and multivariate Logistic regression analysis .Results In all patients ,31 cases were with postoperative complica-tions ,and the incidence rate was 15 .3% .Univariate analysis indicated that equal with or more than 55 years old ,time of cardiopulmonary bypass equal with or more than 2 h ,time of aortic cross clamping time equal with or more than 100 min ,cardiac function of grade Ⅳ and with preoperative complication of high blood pressure ,diabetes or chronic obstructive pulmonary disease were related influencing factors of postoperative complications （P〈0 .05） .Multivari-ate Logistic regression analysis revealed that equal with or more than 55 years old ,time of cardiopulmonary bypass e-qual with or more than 2 h ,time of aortic cross clamping equal with or more than 100 min and cardiac function of grade Ⅳ were independent risk factors of postoperative complications （P〈0 .05） .Conclusion For patients undergo-ing cardiac surgery under cardiopulmonary bypass ,preoperative assess should performed to identify and intervene re-lated risk factors of postoperative complications ,so as to improve the operative safety and efficiency .

关 键 词：体外循环心脏手术 术后并发症 影响因素 

分 类 号：R654.2[医药卫生—外科学]