非体外循环冠状动脉旁路移植术后新发脑梗死的危险因素分析  

Risk factors for acute cerebral infarction following off-pump coronary artery bypass grafting

作　　者：刘春洁[1] 郑海亮[2] 李晓晴[1] 

机构地区：[1]首都医科大学附属北京安贞医院神经内科,100029 [2]首都医科大学附属北京世纪坛医院

出　　处：《中华老年心脑血管病杂志》2016年第6期620-622,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：北京市自然科学基金(1152003)

摘　　要：目的分析非体外循环冠状动脉旁路移植术（OPCABG）术后新发脑梗死的危险因素。方法收集北京安贞医院住院的398例OPCABG患者的临床资料,根据术后是否出现新发脑梗死分为脑梗死组42例和无脑梗死组356例。分析OPCABG术后新发脑梗死的危险因素。结果脑梗死组颈动脉重度狭窄或闭塞、术后低血压及脑梗死病史显著高于无脑梗死组（21.4%vs 3.4%,26.2%vs 9.8%,23.8%vs 4.2%,P〈0.01）。多因素logistic回归分析显示,颈动脉重度狭窄或闭塞伴术后低血压（OR：4.226,95%CI：1.441~12.391,P=0.009）及脑梗死病史（OR：4.113,95%CI：1.499~11.289,P=0.006）是术后新发脑梗死的独立危险因素。结论术前充分评估高危患者的脑血管储备功能,对预防术后新发脑梗死有重要意义。Objective To analyze the risk factors for acute cerebral infarction（ACI）following offpump coronary artery bypass grafting（OPCABG）.Methods Three hundred and ninety-eight patients who underwent OPCABG in our hospital were divided into cerebral infarction（CI）group（n=42）and CI-free group（n=356）.The risk factors for ACI following OPCABG were analyzed.Results The incidence of severe carotid artery stenosis or occlusion and postoperative hypotension was significantly higher and the history of CI was significantly longer in CI group than in CIfree group（21.4%vs 3.4%,26.2% vs 9.8%,23.8% vs 4.2%,P〈0.01）.Multivariate logistic regression analysis showed that severe carotid artery stenosis or occlusion,postoperative hypotension,and history of CI were the independent risk factors for ACI following OPCABG（OR=4.226,95%CI：1.441-12.391,P=0.009;OR=4.113,95%CI：1.499-11.289,P=0.006）.Conclusion Carefull assessment of cerebrovascular reserve function in patients at high risk of CI plays an important role in preventing ACI following OPCABG.

关 键 词：冠状动脉旁路移植术 非体外循环 手术后并发症 脑梗死 

分 类 号：R654.2[医药卫生—外科学]