成人心脏外科术后再次气管插管患者预后危险因素探析  

To analyze prognostic risk factors of adult patients with re endotracheal intubation after cardiac surgery

作　　者：孔万利[1] 张颖[1] 丁莉萍[1] 米玉红[1] KONG wanli;ZHANG ying;DING liping;MI yuhong(Emergency Intensive Care Unit,Beijing Anzhen Hospital,Capital Medical University,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急诊危重症中心,100029

出　　处：《心肺血管病杂志》2022年第7期806-810,共5页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:探析影响心脏外科术后再次气管插管患者预后的危险因素,为临床实践应用提供依据。方法:本研究回顾性纳入我院2021年1月至2021年9月,成人行心脏外科手术后进行再次气管插管患者45例,男性30例(66.7%),女性15例(33.3%),根据患者转归,分成正常出院组和非正常出院(死亡和转院)组,分析两组患者的基线资料、手术方式、既往史、检查和化验室指标、再次气管插管原因、住院时间、ICU滞留时间,分析影响再次气管插管患者预后的相关因素。结果:两组临床基线资料相比,年龄、性别、手术方式均无统计学差异。其中,既往吸烟两组患者具有统计学意义。检查和化验室指标分析:拔管前、拔管后及术后最差左室射血分数、术后低血红蛋白、再次气管插管PH、PaCO_(2)、PaO_(2)指标在两组间差异有统计学意义。再次气管插管原因在两组间差异无统计学意义。两组患者的住院时间及ICU滞留时间均差异有统计学意义(P<0.05),非正常出院组均明显长于正常出院组。结论:既往吸烟、LVEF降低、术后低血红蛋白、再次气管插管PH、PaCO_(2)、PaO_(2)的改变为影响成人心脏外科术后再次气管插管预后的危险因素,影响患者的住院时间和ICU滞留时间,对预后造成不良影响。Objective:To analyze prognosis risk factors of adult patients with endotracheal intubation after cardiac surgery,so as to provide basis for clinical application.Methods:From January 2021 to September 2021,45 adult patients who underwent re endotracheal intubation after cardiac surgery were included in this study retrospectively,including 30 males(66.7%)and 15 females(33.3%).According to the outcome of the patients,they were divided into normal discharge group and abnormal discharge(death and transfer)group.The baseline data,operation mode,past history check and laboratory indexes,length of hospital stay and ICU residence time,and analyze the risk factors of re endotracheal intubation and related factors affecting prognosis.Results:There was no significant difference in age,gender and operation mode between the two groups.Among them,the two groups of patients with previous smoking had statistical significance.Examination and laboratory index analysis:there were significant differences in the worst left ventricular ejection fraction before,after and after extubation,low hemoglobin after operation,pH,PaCO_(2) and PaO_(2) after re endotracheal intubation between the two groups.The reasons for re intubation were not statistically significant between the two groups.The hospitalization time and ICU stay time of the two groups were statistically different(P<0.05),and the abnormal discharge group was significantly longer than the normal discharge group.Conclusions:Previous smoking,decreased left ventricular ejection fraction,low hemoglobin after operation,changes in pH,PaCO_(2) and PaO_(2) of re endotracheal intubation after adult cardiac surgery are risk factors affecting the prognosis of re endotracheal intubation,affecting the length of hospital stay and ICU residence time of patients,and adversely affecting the prognosis.

关 键 词：成人心脏外科术后 再次气管插管预后 危险因素 

分 类 号：R54[医药卫生—心血管疾病]