心脏瓣膜置换术后低心排综合征危险因素的调查分析  

Investigation and analysis of risk factors for low cardiac output syndrome after cardiac valve replacement

作　　者：高敏[1] GAO Min

机构地区：[1]山东大学齐鲁医院心脏外科,济南市250000

出　　处：《护理实践与研究》2020年第22期67-69,共3页Nursing Practice and Research

摘　　要：目的探讨心脏瓣膜置换术后低心排综合征高危因素及干预措施。方法选择2018年7月到2019年7月我院104例心脏瓣膜置换术患者为研究对象,调查术后低心排综合征(LCOS)发生情况以及术后心律失常、电解质紊乱、术前心脏功能等临床资料,以是否发生LCOS为因变量,术后心律失常、术前NYHA分级、围术期失血过多、电解质紊乱、年龄、冠心病史、合并高血压为自变量进行多因素logistic回归分析,明确心脏瓣膜置换术后LCOS危险因素,并探讨预防措施。结果104例心脏瓣膜置换术患者术后发生LCOS 26例,多因素logistic回归分析显示,体质量过轻、术前纽约心功能分级(NYHA)Ⅲ~Ⅳ级、围术期失血过多、电解质紊乱是心脏瓣膜置换术患者术后发生LCOS高危因素。结论心脏瓣膜置换术后易发生LCOS,影响因素包括体质量过轻、术前心功能、失血、电解质紊乱等,应开展围术期针对性护理措施降低LCOS发生率,改善心脏瓣膜置换术预后。Objective To explore the high-risk factors and intervention measures for low cardiac output syndrome(LCOS)after cardiac valve replacement.Methods To select 104 cases of patients undergoing heart valve replacement operation from July 2018 to July 2019 as the study objects,taking the incidence of the LCOS as the dependent variable,postoperative arrhythmia,preoperative NYHA level,perioperative excessive hemorrhage,electrolyte disturbance,age,history of coronary heart disease,associated hypertension as the independent variable to undertake the multi-factor logistic regression analysis,for investigating the occurrence of postoperative LCOS and clinical data such as postoperative arrhythmia,electrolyte disturbances,and preoperative heart function.To investigate the risk factors of LCOS after heart valve replacement and discusses preventive measures.Results The 26 cases of LCOS occurred in 104 cases of patients undergoing heart valve replacement operation.Multivariate logistic regression analysis showed that the low body weight,preoperative New York heart association(NYHA)gradeⅢ~Ⅳ,excessive perioperative blood loss,and electrolyte imbalance were the high risk factors for LCOS in patients undergoing heart valve replacement operation.Conclusion The LCOS was prone to occur after heart valve replacement,and the influencing factors included underweight,preoperative heart function,blood loss,and electrolyte imbalance,etc.Perioperative targeted nursing measures should be implemented to reduce the incidence of LCOS and improve the prognosis of heart valve replacement.

关 键 词：心脏瓣膜置换术 低心排综合征 危险因素 

分 类 号：R473.6[医药卫生—护理学]