本文選題：非體外循環(huán)冠狀動脈搭橋術(shù) + 主動脈內(nèi)球囊反搏��； 參考：《廣西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的探討我院主動脈內(nèi)球囊反搏輔助非體外循環(huán)冠狀動脈搭橋術(shù)患者住院死亡的危險因素,以期為主動脈內(nèi)球囊反搏在臨床中的應(yīng)用提供參考。方法對2013年6月至2017年1月在我院行非體外循環(huán)冠脈搭橋術(shù)(OPCAB)圍術(shù)期輔助應(yīng)用主動脈內(nèi)球囊反搏(IABP)的58例患者資料進(jìn)行回顧性分析,根據(jù)患者在住院期間是否死亡將患者分為存活組和死亡組,采集與比較兩組患者的臨床資料,包括性別、年齡、術(shù)前造影病變血管數(shù)、是否合并左主干病變、是否并存高血壓、糖尿病、血脂異常與腦卒中等疾病、運用IABP的時機、術(shù)中是否緊急轉(zhuǎn)流、術(shù)后是否存在器官功能衰竭、是否進(jìn)行血液透析治療、術(shù)后1周內(nèi)生化指標(biāo)的峰值如心肌型肌酸激酶同功酶(CK-MB)、肌酐、腦利鈉肽前體(pro-BNP)、總膽紅素、肌鈣蛋白I及住院時間等相關(guān)指標(biāo)進(jìn)行多因素回歸分析,探討患者住院死亡的危險因素。結(jié)果多因素回歸分析顯示,術(shù)前預(yù)防性應(yīng)用IABP(OR=0.43,P0.05)是患者住院死亡的保護(hù)性因素。合并左主干病變(OR=2.509,P0.05)是患者住院死亡的獨立危險因素。結(jié)論IABP輔助下行OPCAB術(shù)的患者,術(shù)前預(yù)防性應(yīng)用IABP可降低住院死亡風(fēng)險,而合并左主干病變住院死亡風(fēng)險度增高。
[Abstract]:Objective to investigate the risk factors of in-hospital death in patients undergoing non-cardiopulmonary bypass coronary artery bypass (CABG) with intra-aortic balloon counterpulsation (IABP) in order to provide reference for the clinical application of intra-aortic balloon counterpulsation (IABP). Methods from June 2013 to January 2017, 58 patients who underwent off-pump coronary artery bypass grafting (OPCAB) with intraaortic balloon counterpulsation (IABP) during perioperative period were retrospectively analyzed. The patients were divided into survival group and death group according to whether the patient died during hospitalization. The clinical data of the two groups were collected and compared, including sex, age, the number of angiographic lesions before operation, whether the patients were complicated with left main lesion, whether they co-existed with hypertension. Diabetes mellitus, dyslipidemia, stroke and other diseases, the timing of the use of IABP, whether there is an emergency bypass during the operation, whether there is organ failure after the operation, whether to undergo hemodialysis, The peak value of biochemical indexes such as CK-MBN, creatinine, pro-BNPN, total bilirubin, troponin I and hospitalization time were analyzed by multivariate regression analysis within 1 week after the operation, including myocardial creatine kinase isoenzyme, creatinine, brain natriuretic peptide precursor pro-BNPN, total bilirubin, troponin I and hospitalization time. To investigate the risk factors of death in hospital. Results the multivariate regression analysis showed that preoperative prophylactic use of IABP0. 43 (P 0. 05) was the protective factor of death in hospital. The patients with left main lesion were independent risk factors of death in hospital (P 0.05). Conclusion preoperative prophylactic use of IABP can reduce the risk of hospital death in patients with IABP assisted OPCAB surgery, while the risk of hospitalization death with left main lesion is higher.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R614

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本文編號：1911861