冠状动脉旁路移植术后发生低心排综合征危险因素的meta分析  

Meta-analysis of risk factors of low cardiac output syndrome after coronary artery bypass grafting

作　　者：姜若曦 杨少娣 马丽慧 曾海丽[1] 黄丽茹 陆惠慧 JIANG Ruoxi;YANG Shaodi;MA Lihui;ZENG Haili;HUANG Liru;LU Huihui(Department of Cardiovascular and Vascular Surgery,Qingyuan Hospital Affiliated to Guangzhou Medical University,the People’s Hospital in Qingyuan City,Guangdong,Qingyuan 511500,China;Department of Nursing,Qingyuan Hospital Affiliated to Guangzhou Medical University,the People’s Hospital in Qingyuan City,Guangdong,Qingyuan 511500,China)

机构地区：[1]广州医科大学附属清远医院广东省清远市人民医院心脏大血管外科,广东清远511500 [2]广州医科大学附属清远医院广东省清远市人民医院护理部,广东清远511500

出　　处：《中国医药科学》2025年第2期79-83,共5页China Medicine And Pharmacy

基　　金：广东省清远市社会发展领域自筹经费科技计划项目(200727104561374)。

摘　　要：目的通过meta分析探讨冠状动脉旁路移植(CABG)术后患者发生低心排血量综合征(LCOS)的危险因素。方法中、外文相关文献经过检索、筛选、资料提取、质量评价和meta分析。结果最终纳入14篇文献,涉及12605例患者资料。meta分析结果显示三支血管病变[OR=1.12,95%CI(0.28,4.47)]差异无统计学意义(P>0.05)。meta分析得出CABG术后发生LCOS的危险因素为心律失常[OR=7.22,95%CI(4.93,10.58)]、心肌梗死[OR=2.28,95%CI(1.65,3.14)]、糖尿病[OR=1.72,95%CI(1.45,2.04)]、脑梗死[OR=4.63,95%CI(2.01,10.65)]、紧急手术[OR=2.61,95%CI(2.24,3.04)]、急性肾功能衰竭[OR=3.80,95%CI(2.16,6.70)]、左心室射血分数低[OR=3.50,95%CI(2.17,5.66)]、年龄≥60岁[OR=2.47,95%CI(1.71,3.56)]、不完全血运重建[OR=0.33,95%CI(0.24,0.46)]、左主干病变[OR=1.97,95%CI(1.11,3.51)]、肌酐高[WMD=15.94,95%CI(7.26,24.61)]、术中失血量大[WMD=189.07,95%CI(148.07,230.07)]和手术时间长[WMD=0.68,95%CI(0.45,0.90)]。结论在当前现有证据情况下,meta分析得到13个CABG术后发生LCOS的有效危险因素。Objective To investigate the risk factors of low cardiac output syndrome(LCOS)after coronary artery bypass grafting(CABG)by meta-analysis.Methods Relevant documents in Chinese and foreign languages were searched,screened,extracted,evaluated and analyzed by meta-analysis.Results Finally,14 articles were included,involving data from 12605 patients.The meta-analysis results showed that there was no statistically significant difference(P>0.05)in 3 vessel lesions(OR=1.12,95%CI[0.28,4.47]).Meta analysis showed that the risk factors for LCOS after CABG were in the following.They were arrhythmia(OR=7.22,95%CI[4.93,10.58]),myocardial infarction(OR=2.28,95%CI[1.65,3.14]),diabetes(OR=1.72,95%CI[1.45,2.04]),cerebral infarction(OR=4.63,95%CI[2.01,10.65]),emergency surgery(OR=2.61,95%CI[2.24,3.04]),acute renal failure(OR=3.80,95%CI[2.16,6.70]),left ventricular ejection low score(OR=3.50,95%CI[2.17,5.66]),age≥60 years(OR=2.47,95%CI[1.71,3.56]),incomplete revascularization(OR=0.33,95%CI[0.24,0.46]),left main artery disease(OR=1.97,95%CI[1.11,3.51]),high creatinine(WMD=15.94,95%CI[7.26,24.61]),large intraoperative hemorrhage(WMD=189.07,95%CI[148.07,230.07])and long operation time(WMD=0.68,95%CI[0.45,0.90]).Conclusion Based on the existing evidence,13 effective risk factors of LCOS after CABG were obtained by meta-analysis.

关 键 词：冠状动脉旁路移植术 低心排综合征 危险因素 META分析 

分 类 号：R654.2[医药卫生—外科学]