本文關(guān)鍵詞：體外循環(huán)下成人心臟手術(shù)圍手術(shù)期出血危險(xiǎn)因素分析　出處：《寧夏醫(yī)科大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 體外循環(huán) 心臟手術(shù) 出血 危險(xiǎn)因素

【摘要】：目的:篩選體外循環(huán)(Cardiopulmonary bypass,CPB)下成人心臟手術(shù)圍手術(shù)期出血的危險(xiǎn)因素。方法:收集寧夏醫(yī)科大學(xué)總醫(yī)院心臟大血管外科自2012年1月-2014年12月體外循環(huán)下成人心臟手術(shù)患者的臨床資料作為研究對(duì)象;查閱文獻(xiàn)后確定與圍手術(shù)期出血相關(guān)的潛在危險(xiǎn)因素;將所有研究對(duì)象共計(jì)570例分為兩組,出血組(68例)及非出血組(502例);對(duì)潛在危險(xiǎn)因素進(jìn)行單因素分析和logistic多因素回歸分析,從而篩選出圍手術(shù)期出血的危險(xiǎn)因素。結(jié)果:納入研究對(duì)象共計(jì)570例,其中發(fā)生圍手術(shù)期出血的共計(jì)68例,經(jīng)單因素分析發(fā)現(xiàn)圍手術(shù)期出血的危險(xiǎn)因素為:CPB轉(zhuǎn)流時(shí)間≥120min(P=0.000)、手術(shù)類型(P=0.000)、術(shù)前心功能(NYHA)分級(jí)≥III級(jí)(P=0.000)、是否使用止血藥物(P=0.000)、止血藥物類型(P=0.000)、術(shù)前Hct水平(P=0.004)、BMI(P=0.013)、年齡(P=0.048)。經(jīng)Logistic多因素回歸分析顯示,CPB轉(zhuǎn)流時(shí)間、心功能分級(jí)、是否使用止血藥物、手術(shù)類型及BMI為我院圍手術(shù)期出血的獨(dú)立危險(xiǎn)因素。結(jié)論:1.在行體外循環(huán)心臟手術(shù)的患者中,CPB轉(zhuǎn)流時(shí)間、心功能分級(jí)、是否使用止血藥物、手術(shù)類型及BMI均為圍手術(shù)期出血的獨(dú)立危險(xiǎn)因素。2.本研究為單中心研究,樣本量較小,臨床數(shù)據(jù)存在部分缺失,對(duì)研究的最終結(jié)果可能會(huì)產(chǎn)生一定的影響,討論不夠全面,仍需長(zhǎng)期觀察并驗(yàn)證。
[Abstract]:Objective: to screen cardiopulmonary bypass during cardiopulmonary bypass (CPB). CPB). Risk factors of perioperative bleeding in adult patients undergoing cardiac surgery. Methods:. The clinical data of adult patients undergoing cardiopulmonary bypass from January 2012 to December 2014 in the Department of Cardiovascular surgery in the General Hospital of Ningxia Medical University were collected as the research objects. The potential risk factors associated with perioperative hemorrhage were identified after literature review. A total of 570 cases were divided into two groups: 68 cases of bleeding group (n = 68) and 502 cases of non-bleeding group (n = 502). The risk factors of perioperative bleeding were screened by univariate analysis and logistic multivariate regression analysis. Results: a total of 570 patients were included in the study. A total of 68 cases of perioperative bleeding were found. The risk factors of perioperative bleeding were found to be 鈮，

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