探讨心脏术后缺氧性肝炎患者的临床特征  

To investigate the clinical features of hypoxic hepatitis after cardiac surgery

作　　者：崔岩[1] 姜晓宇 闫真[1] 张杰[1] CUI Yan;JIANG Xiaoyu;YAN Zhen;ZHANG Jie(Department of Gastroenterology,Beijing Anzhen Hospital,Capital,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消化内科,100029

出　　处：《心肺血管病杂志》2025年第1期32-37,共6页Journal of Cardiovascular and Pulmonary Diseases

基　　金：国家自然科学基金(81702324)。

摘　　要：目的:分析心脏术后缺氧性肝炎(hypoxic hepatitis,HH)患者的临床特征。方法:回顾性分析2022年1月1日至2022年12月30日,在首都医科大学附属北京安贞医院心脏外科,缺氧性肝炎患者122例的临床资料,分为生存组和死亡组。结果:心脏术后缺氧性肝炎患者住院死亡率高达58.2%。死亡组在术后Lac、Cr和顺序器官衰竭评估评分(sequential organ failure assessment score,SOFA Score)等显著高于生存组(P <0.05)。死亡组在术前白蛋白(albumin,ALB)和HGB、术后PaO_(2)/FiO_(2)、术后LVEF等方面显著低于生存组(P <0.05)。死亡组在低心排综合征(low cardiac output syndrome,LCOS)、急性心力衰竭、恶性心律失常和心脏骤停、急性肾衰竭、脓毒性休克等多脏器功能衰竭(multiple organ failure,MODS)等方面显著升高(P <0.05)。结论:心脏术后缺氧性肝炎患者死亡率高,术前要关注有无低白蛋白和贫血,术后关注心功能、肾功能、呼吸功能,发现脏器功能衰竭及时干预。Objective:To analyze the clinical features of patients with hypoxic hepatitis(HH)after cardiac surgery.Methods:Clinical data of 122 patients with hypoxic hepatitis admitted to the Department of Cardiac Surgery,Beijing Anzhen Hospital,Capital Medical University from January 1,2022 to December 30,2022 were retrospectively analyzed and divided into survival group and death group.Results:The in-hospital mortality of patients with hypoxic hepatitis after cardiac operation was 58.2%.The levels of lactic acid(Lac),Cr and SOFA Score in death group were significantly higher than those in survival group(P<0.05).The preoperative albumin(ALB)and HGB,postoperative oxygenation index(PaO_(2)/FiO_(2))and postoperative LVEF in the death group were significantly lower than those in the survival group(P<0.05).As for other complications after cardiac surgery,the death group had significantly higher rates of low cardiac production syndrome(LCOS),acute heart failure,malignant arrhythmia and cardiac arrest,acute renal failure,septic shock and multiple organ failure(MODS)(P<0.05).Conclusions:Patients with hypoxic hepatitis after cardiac surgery have a high mortality rate.Preoperative attention should be paid to the presence of low albumin and anemia,while postoperative attention should be paid to heart function,kidney function,and respiratory function.If organ failure is detected,timely intervention should be taken.

关 键 词：心脏手术 缺氧性肝炎 缺血性肝炎 休克肝 死亡率 

分 类 号：R54[医药卫生—心血管疾病]