非体外循环下冠状动脉旁路移植术后低氧血症的危险因素分析

Risk factors for hypoxemia after off pump coronary artery bypass grafting

  • 摘要: 目的 探讨非体外循环下冠状动脉旁路移植术(off pump coronary artery bypass grafting,OPCAB)后低氧血症发生的危险因素,为临床OPCAB术后低氧血症的防治提供依据。 方法 回顾性分析我院2004年3月-2012年8月208例OPCAB患者的临床资料,根据OPCAB术后是否出现低氧血症将患者分为低氧血症组和非低氧血症组,采用单因素和多因素分析方法探讨OPCAB术后低氧血症发生的危险因素。 结果 208例中61例符合OPCAB术后低氧血症标准,低氧血症发生率为29.3%。单因素分析显示低氧血症组和非低氧血症组比较:年龄、体质量指数、既往吸烟史、心功能(NYHA)Ⅲ~Ⅳ级、三支病变、心脏射血分数(ejection fraction,EF)< 30%、心源性休克、急诊手术差异有统计学意义(P< 0.05)。多因素Logistic回归分析显示:年龄、体质量指数、既往吸烟史、心功能(NYHA)Ⅲ~Ⅳ级、三支病变、EF< 30%、急诊手术为OPCAB术后发生低氧血症的独立危险因素。 结论 OPCAB术后低氧血症的发生与年龄、体质量指数、既往吸烟史、心功能(NYHA)Ⅲ~Ⅳ级、三支病变、EF< 30%、急诊手术等多个因素有关。

     

    Abstract: Objective To provide the evidence for the prevention and treatment of hypoxemia after off pump coronary artery bypass grafting (OPCAB) by studying its risk factors. Methods The clinical data about 208 patients who underwent OPCAB in our hospital from March 2004 to August 2012 were retrospectively analyzed. The patients were divided into non-hypoxemia group and hypoxemia group according to the occurrence of hypoxemia after OPCAB. The risk factors for hypoxemia after OPCAB were studied by univariate and multivariate analysis. Results Of the 208 patients, 61 (29.3%) developed hypoxemia after OPCAB. Univariate analysis revealed that age, BMI, smoking, NYHA class Ⅲ-Ⅳ, triple-vessel disease, EF< 30%, cardiogenic shock, and emergent procedure were signifcantly different between non-hypoxemia group and hypoxemia group (P< 0.05). Multivariate logistic regression analysis showed that age, BMI, smoking, NYHA class Ⅲ-Ⅳ, triple-vessel disease, EF< 30%, and emergent procedure were the independent risk factors for hypoxemia after OPCAB. Conclusion Hypoxemia after OPCAB is related with age, BMI, smoking, NYHA class Ⅲ-Ⅳ, triple-vessel disease, EF< 30%, and emergent procedure.

     

/

返回文章
返回