心肺转流下心血管手术孕妇死亡的危险因素分析  

Risk factors of maternal mortality in cardiovascular surgery with cardiopulmonary bypass during pregnancy

作　　者：董秀华 卢家凯 程卫平 马骏 赵丽云 景赫 曹亮 孙雨薇 DONG Xiuhua;LU Jiakai;CHENG Weiping;MA Jun;ZHAO Liyun;JING He;CAO Liang;SUN Yuwei(Department of Anesthesiology,Beijing Anzhen Hospital,Capital Medical Uni-versity,Beijing Institute of Heart,Lung and Blood Vessel Diseases,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院北京市心肺血管疾病研究所麻醉科,100029

出　　处：《临床麻醉学杂志》2018年第10期967-969,共3页Journal of Clinical Anesthesiology

基　　金：国家卫生和计划生育委员会-公益性行业科研专项项目(201402009);北京市科技重大专项课题(Z171100001017083);北京市自然科学基金资助项目(7152046)

摘　　要：目的分析心肺转流(cardiopulmonary bypass,CPB)下心血管手术孕妇死亡的危险因素。方法回顾性分析我院35例孕妇行CPB下心血管手术的围术期资料,年龄22～37岁,将对孕妇死亡有明显影响的单因素纳入多因素Logistic回归分析。结果术后孕妇死亡5例,病死率为14.3%(5/35例)。单因素分析显示,术前NYHA心功能4级、手术时间、ICU留观时间、术后心力衰竭、术后透析对孕妇行CPB下心血管手术死亡有明显影响(P<0.05)。多因素Logistic回归分析未能检测出孕妇行CPB下心血管手术死亡的独立危险因素。结论术前NYHA心功能4级、手术时间、ICU留观时间、术后心力衰竭、术后透析为孕妇行CPB下心血管手术死亡的危险因素。Objective To explore the risk factors of maternal mortality in cardiovascular surgery with cardiopulmonary bypass during pregnancy.Methods The data of 35 pregnant women aged22-37 years,performed cardiovascular surgeries under cardiopulmonary bypass were retrospectively analyzed.The risk factors were determined by univariate analysis and multiple logistic regression.Results Five women died postoperatively,the maternal mortality was 14.3%（5/35 cases）.New York Heart Association（NYHA）functional classification of 4,operation time,length of intensive care unit（ICU）stay,postoperative heart failure and dialysis were risk factors of maternal mortality by univariate analysis.Multiple logistic regression could not show an independent predictor of maternal mortality in cardiovascular surgery with cardiopulmonary bypass during pregnancy.Conclusion NYHA of 4,operation time,length of ICU stay,postoperative heart failure and dialysis were risk factors of maternal mortality in cardiovascular surgery with cardiopulmonary bypass during pregnancy.

关 键 词：孕妇 心血管手术 心肺转流 死亡 危险因素 

分 类 号：R654.2[医药卫生—外科学]