心脏瓣膜疾病患者术后发生低心排血量综合征危险因素的Meta分析  

A Meta-analysis of risk factors for postoperative low cardiac output syndrome in patients with heart valve disease

作　　者：黄翱黎 陈霞[1] HUANG Aoli;CHEN Xia

机构地区：[1]浙江大学医学院附属第一医院心脏大血管外科,杭州市310003

出　　处：《中华急危重症护理杂志》2023年第9期798-804,共7页Chinese Journal of Emergency and Critical Care Nursing

摘　　要：目的通过Meta分析明确心脏瓣膜疾病患者术后发生低心排血量综合征(low cardiac output syndrome,LCOS)的危险因素,为早期识别、预防、改善患者低心排血量综合征提供依据。方法检索中国知网、万方数据库、维普数据库、中国生物医学文献数据库、PubMed、CINAHL、Web of Science、Embase,筛选建库至2022年12月心脏瓣膜疾病患者术后发生LCOS危险因素的相关研究,评价文献质量后,应用RevMan 5.4软件进行Meta分析。结果共纳入11篇文献,包含2117例患者。体质量过轻(OR=3.59)、体质量过重(OR=1.34)、高龄(OR=3.74)、合并高血压(OR=2.84)、肺动脉高压(WMD=27.28)、术前心功能障碍(OR=20.52)、术前水电解质紊乱(OR=3.42)、术前肾功能不全(OR=3.00)、术后心律失常(OR=4.34)、术中失血量比过高(OR=3.76)、术后失血量比过高(OR=4.48)、术中体外循环时间(OR=1.63)及主动脉阻断时间过长(OR=3.18)、未使用超滤(OR=0.27)为心脏瓣膜疾病患者术后发生LCOS的危险因素。结论医护人员可根据上述危险因素及早对患者进行LCOS的风险预警评估判断、预防、处理,以采取相关干预措施防止或改善患者LCOS相关症状。Objective To identify the risk factors for low cardiac output syndrome(LCOS)in patients with heart valve disease after surgery by meta-analysis and to provide a basis for early identification,prevention and improve-ment of low cardiac output syndrome.Methods The relevant articles about postoperative LCOS risk factors in pa-tients with heart valve disease published from inception to December 2022 were searched in CNKI,Wanfang,VIP databale,CBM database,PubMed,CINAHL,Web of Science,Embase.After evaluating the quality of the literatures,the RevMan 5.4 software was used for meta-analysis.Results A total of 11 articles were included,with a total sample size of 2117 cases.The risk factors of postoperative patients with LCOS were underweight(OR=3.59)or overweight(OR=1.34),old age(OR=3.74),hypertension(OR=2.84),pulmonary hypertension(WMD=27.28),preoperative cardiac dysfunction(OR=20.52),water-electrolyte disorder(OR=3.42),preoperative renal insufficiency(OR=3.00),postoperative arrhythmia(OR=4.34),excessive intraoperative blood loss(OR=3.76)and postoperative blood loss(OR=4.48),long cardiopulmonary bypass time(OR=1.63),long aortic cross clamp time(OR=3.18),not use of intraoperative ultrafiltration(OR=0.27).Conclusion According to the above risk factors,medical staff can make early risk warning judgement,prevention and treatment of LCOS patients,so as to take relevant interventions to prevent or improve LCOS-related symptoms of patients.

关 键 词：心排血量 低 心脏瓣膜疾病 危险因素 META分析 循证护理学 

分 类 号：R654.2[医药卫生—外科学]