右美托咪定对体外循环心脏手术患者术后房颤的影响  

Effect of dexmedetomidine on postoperative atrial fibrillation after cardiac surgery under cardiopulmonary bypass

作　　者：饶倩倩 玉红[1] 周荣华[2] 余海[1] Rao Qianqian;Yu Hong;Zhou Ronghua;Yu Hai(Department of Anesthesiology,West China Hospital of Sichuan University,Sichuan Chengdu 610041,China)

机构地区：[1]四川大学华西医院麻醉科,成都610041 [2]四川大学华西天府医院麻醉手术中心,成都610213

出　　处：《中国体外循环杂志》2024年第6期469-472,477,共5页Chinese Journal of Extracorporeal Circulation

摘　　要：目的评估右美托咪定对成人体外循环手术患者术后房颤(POAF)的影响。方法从四川大学华西医院电子病历信息管理系统及麻醉手术临床信息系统中回顾性筛选2018年3月至2020年12月在体外循环下进行心脏手术的患者910例,根据术中是否使用右美托咪定分为右美组(n=255)和非右美组(n=655),两组采用1∶1倾向性得分匹配分析法分析两组术后房颤发生率等结局资料。结果共有253对匹配成功,匹配后两组间基线资料差异无统计学意义。右美组术后3 d内发生POAF 29例(11.5%),非右美组23例(9.1%),两组无统计学差异(P=0.644)。两组患者在术后急性肾损伤发生率(P=0.326)、ICU住院时间(P=0.281)及住院总费用(P=0.785)的差异无统计学意义。右美组在术后住院时间显著低于非右美组(P=0.041)。结论在体外循环下行心脏手术的成年患者中,术中右美托咪定的使用不影响术后房颤的发生风险。Objective To investigate the association of dexmedetomidine with the occurrence of postoperative atrial fibrillation(POAF)in adult patients undergoing elective cardiac surgery with cardiopulmonary bypass(CPB).Methods Retrospective analysis was performed on the electronic medical records of 910 patients who underwent elective cardiac surgery under CPB at West China Hospital,Sichuan University from March 2018 to December 2020.A total of 910 patients who underwent heart surgery with CPB were selected and divided into the dexmedetomidine group(n=255)and the non-dexmedetomidine group(n=655)based on whether dexmedetomidine was administered intraoperatively.The propensity score matching(PSM)method was used for 1:1 matching,and the incidence of POAF and other outcome data of the two groups were compared.Results After matching,there was no significant difference in the baseline data between the two groups,with 253 patients in each group correctly matched.There were 29 cases(11.5%)of POAF in dexmedetomidine group and 23 cases(9.1%)in non-dexmedetomidine group within 3 days after operation.There was no significant difference in the incidence of POAF between the two groups(P>0.05).Furthermore,no significant differences were observed between the two groups concerning the incidence of postoperative acute kidney injury(AKI)(P=0.326),ICU length of stay(P=0.281)and total hospitalization cost(P=0.785).Postoperative hospital length of stay in dexmedetomidine group was significantly shorter than that in non-dexmedetomidine group(P=0.041).Conclusion The administration of intraoperative dexmedetomidine has no effect on the risk of POAF in adult patients undergoing cardiac surgery under CPB.

关 键 词：右美托咪定 体外循环 心脏手术 术后房颤 倾向性评分匹配 

分 类 号：R54[医药卫生—心血管疾病]