COPD患者行体外循环与非体外循环冠状动脉旁路移植术后不良事件的差异比较  

Comparison of adverse events after on-pump and off-pump coronary artery bypass grafting in patients with COPD

作　　者：叶晓芳[1] 曾文[2] 杨京华[1] 朱光发[1] Ye Xiaofang;Zeng Wen;Yang Jinghua;Zhu Guangfa(Department of Respiratory and Critical Care Medicine,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute 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呼吸与危重症医学科,北京100029 [2]首都医科大学附属北京安贞医院心血管外科,北京100029

出　　处：《中华胸心血管外科杂志》2023年第6期341-347,共7页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：目的:探讨慢性阻塞性肺疾病(COPD)患者接受体外循环下冠状动脉旁路移植(ONCABG)和非体外循环下冠状动脉旁路移植(OPCABG)术后不良事件的差异。方法:回顾性分析2021年1月至2021年12月首都医科大学附属北京安贞医院收治的CABG手术的COPD患者临床资料,按照是否接受体外循环,分为ONCABG组(64例)及OPCABG组(154例),对其术前、术中、术后的临床资料进行分析。按照FEV160%为分界点分为4个亚组(ON1、ON2、OP1、OP2),探讨术后不良事件的差异。结果:共纳入218例患者,年龄45~76岁,平均(63.81±7.72)岁,其中男149例(68.35%)。ONCABG组和OPCABG组在术后不良事件发生率方面差异无统计学意义( P>0.05)。亚组分析中,ON1(FEV1≤60% ONCABG,22例)组术后肺部感染(72.73%对45.65%, P<0.05)、术后心房颤动(59.09%对32.61%, P<0.05)的发生率高于OP1(FEV1≤60% OPCABG,46例)组。 结论:FEV1≤60% COPD患者ONCABG术后肺部感染、心房颤动的发生率高于OPCABG。ObjectiveTo investigate the difference of adverse events in patients with chronic obstructive pulmonary disease(COPD)who underwent on-pump coronary artery bypass grafting(ONCABG)and off-pump coronary artery bypass grafting(OPCABG).MethodsThe clinical data of COPD patients undergoing CABG surgery admitted to Beijing Anzhen Hospital affiliated to Capital Medical University from January 2021 to December 2021 were retrospectively analyzed.According to whether they received cardiopulmonary bypass or not,they were divided into ONCABG group(64 cases)and OPCABG group(154 cases).The preoperative and postoperative clinical data were analyzed.The whole group was divided into 4 subgroups(ON1、ON2、OP1、OP2)according to whether receiving cardiopulmonary bypass or not and FEV160% as the cut-off point,to investigate the difference of postoperative adverse events.ResultsA total of 218 patients were included,ranging in age from 45 to 76 years old,with a mean age of(63.81±7.72)years,including 149 males(68.35%).There was no significant difference in the incidence of postoperative adverse events between the ONCABG and OPCABG groups(P>0.05).In subgroup analysis,the incidence of postoperative pulmonary infection(72.73% vs.45.65%,P<0.05)and postoperative atrial fibrillation(59.09%vs.32.61%,P<0.05)was higher in ON1(FEV1≤60% ONCABG,22 cases)group than in OP1(FEV1≤60% OPCABG,46 cases)group.ConclusionThe incidence of postoperative pulmonary infection and atrial fibrillation in COPD patients with FEV1≤60%was higher in ONCABG than in OPCABG.

关 键 词：肺部感染 体外循环下冠状动脉旁路移植 非体外循环下冠状动脉旁路移植 慢性阻塞性肺疾病 心房颤动 

分 类 号：R654.2[医药卫生—外科学] R563.9[医药卫生—临床医学]