【摘要】：目的探討非體外循環(huán)下冠狀動(dòng)脈旁路移植術(shù)術(shù)后死亡患者的臨床特點(diǎn)及死亡原因分析。方法收集寧夏醫(yī)科大學(xué)總醫(yī)院心臟大血管外科行非體外循環(huán)下冠狀動(dòng)脈旁路移植術(shù)治療的患者的臨床資料作為研究對(duì)象,確定潛在相關(guān)的危險(xiǎn)因素,從其臨床資料中收集數(shù)據(jù),對(duì)影響手術(shù)死亡的危險(xiǎn)因索進(jìn)行單因素分析和logistic多因素回歸分析,探究施行非體外循環(huán)下冠狀動(dòng)脈旁路移植術(shù)術(shù)后死亡患者的臨床特點(diǎn),并分析我院冠狀動(dòng)脈旁路移植術(shù)術(shù)后死亡的相關(guān)危險(xiǎn)因素。結(jié)果收集整理我院行非體外循環(huán)下冠狀動(dòng)脈旁路移植術(shù)治療患者437例,死亡14例,手術(shù)死亡率3.20%(14/437),手術(shù)死亡患者平均年齡(62.7±2.7)歲,死亡患者男:女=9:5。單因素分析與患者術(shù)后死亡的危險(xiǎn)因素:術(shù)前合并腦梗塞病史、腎功能不全、術(shù)前心功能(NYHA)分級(jí)≥III級(jí)、合并三尖瓣關(guān)閉不全病史、左心室射血分?jǐn)?shù)(LVEF)50%、術(shù)后的惡性心律失常(室顫)、術(shù)后切口感染、術(shù)后肺感染、術(shù)后低心排綜合征、術(shù)后橋血管出血、術(shù)后腎功能衰竭、術(shù)后呼吸衰竭、術(shù)后多臟器衰竭。經(jīng)Logistic多因素回歸分析顯示,術(shù)后患者死亡的獨(dú)立危險(xiǎn)因素為:術(shù)后呼吸衰竭、左心室射血分?jǐn)?shù)(LVEF)50%。結(jié)論1、患者術(shù)前合并腦梗塞病史、腎功能不全、術(shù)前心功能(NYHA)分級(jí)≥III級(jí)、合并三尖瓣關(guān)閉不全病史、左心室射血分?jǐn)?shù)(LVEF)50%、術(shù)后的惡性心律失常(室顫)、術(shù)后切口感染、術(shù)后肺感染、術(shù)后低心排綜合征、術(shù)后橋血管出血、術(shù)后腎功能衰竭、術(shù)后呼吸衰竭、術(shù)后多臟器衰竭等為非體外循環(huán)下冠狀動(dòng)脈旁路移植術(shù)術(shù)后死亡的危險(xiǎn)因素,可以評(píng)估非體外循環(huán)下冠狀動(dòng)脈旁路移植術(shù)的住院死亡風(fēng)險(xiǎn);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)最終結(jié)果可能會(huì)產(chǎn)生一定的影響,擴(kuò)大本文研究樣本量及長(zhǎng)期觀察并驗(yàn)證,對(duì)于進(jìn)一步明確患者術(shù)后死亡危險(xiǎn)因素具有重要的臨床意義。
[Abstract]:Objective to investigate the clinical features and causes of death after off-pump coronary artery bypass grafting (CABG). Methods the clinical data of patients undergoing off-pump coronary artery bypass grafting (CABG) in cardiac macrovascular surgery department of Ningxia Medical University General Hospital were collected as study subjects to identify potential risk factors and collect data from their clinical data. Univariate analysis and logistic multivariate regression analysis were performed to investigate the clinical characteristics of patients who died after off-pump coronary artery bypass grafting (CABG). The risk factors of death after coronary artery bypass grafting in our hospital were analyzed. Results 437 patients underwent off-pump coronary artery bypass grafting in our hospital, 14 patients died. The operative mortality rate was 3.20% (14 / 437). The average age of the patients died was (62.7 鹵2.7) years. Univariate analysis and risk factors of death after operation: preoperative history of cerebral infarction, renal insufficiency, preoperative (NYHA) grade 鈮，

本文編號(hào)：2149128