被动吸烟对冠状动脉搭桥术后低氧血症的影响  

Effects of passive smoking on postoperative hypoxemia after coronary artery bypass grafting

作　　者：栗志勇[1] 常俊伟 张悟麟[1] 刘海燕 

机构地区：[1]河南安阳市第三人民医院心胸外科,河南安阳455000

出　　处：《医学研究与教育》2018年第1期31-36,共6页Medical Research and Education

摘　　要：目的评估被动吸烟对冠状动脉旁路移植术(coronary artery bypass grafting,CABG)后低氧血症的影响。方法选取拟体外循环下CABG患者126人,分为不吸烟组和被动吸烟组,后者根据每周暴露时间进一步分为3个亚组:<10 h、10~20 h、>20 h组。首先监测CABG术后各组低氧血症发病情况,其次记录各组患者的机械通气时间和ICU停留时间。应用Logistic分析观察被动吸烟情况与术后低氧血症的关系。结果 4组低氧血症发生率比较,差异有统计学意义(P<0.01);各组低氧血症发生率分别为20.00%、25.93%、55.56%、59.26%,依次增高;被动吸烟组机械通气时间和ICU停留时间长于不吸烟组,差异有统计学意义(P<0.05)。结论被动吸烟是CABG术后低氧血症的危险因素,被动吸烟增加CABG术后低氧血症发生率,延长术后机械通气时间和ICU停留时间。随着暴露时间增加,低氧血症发病率呈递增趋势。Objective To evaluate the effects of passive smoking on postoperative hypoxemia （POH） of on-pumpcoronary artery bypass grafting surgery patients. Methods 126 patients were undergone on-pump CABG surgery.The patients were divided into non-smokers and passive smokers, the latter were further divided into the follow-ing 3 sub-groups according to exposure time： 〈10 h per week, 10-20 h and 〉20 h per week. The primary out-come measure was the incidence of POH after CABG surgery in each group. Secondary outcomes included lengthof postoperative mechanical ventilation and ICU stay . Logistic analysis was used to observe the relationship be-tween passive smoking and postoperative hypoxemia. Results There was a significant difference in the incidence ofPOH in the 4 groups （P〈0. 01）, The incidence of hypoxemia （20.00%, 25.93%, 55.56% and 59.26%, re-spectively） in each group increased successively. The length of postoperative mechanical ventilation and ICU staywere longer in passive smokers than that in non-smokers （P〈0- 05）. Conclusion Passive smoking is a risk factor ofPOH after CABG surgery , passive smoking can increase POH incidence after on - pump CABG surgery , and it also can prolong the length of postoperative mechanical ventilation and ICU stay. With the increase of exposuretime, the incidence of POH also shows increasing trend.

关 键 词：被动吸烟 冠状动脉旁路移植术 体外循环 低氧血症 

分 类 号：R54[医药卫生—心血管疾病]