冠心病患者冠状动脉旁路移植术近期预后的影响因素分析
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(1.华南理工大学医学院,广东省广州市 510006;2.广东省人民医院 广东省医学科学院流行病研究室,广东省广州市 510080 ;3.广东省人民医院 广东省医学科学院心血管外科,广东省广州市 510080;4.广东省人民医院 广东省医学科学院介入导管室,广东省广州市 510080;5.广东省心血管病研究所,广东省广州市 510080)

作者简介:

席悦,硕士研究生,研究方向为心血管疾病的影像学诊断,E-mail为838502287@qq.com。通信作者袁海云,博士,副主任医师,硕士研究生导师,研究方向为心外科疾病的综合治疗,E-mail为yhy_yun@163.com。

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基金项目:

广东省自然科学基金(2018A030313785,2017A030312007)


Analysis of factors affecting the perioperative prognosis of patients with coronary artery bypass grafting
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1.School of Medicine, South China University of Technology, Guangzhou, Guangdong 510006, China;2.Department of Epidemiology, ;3.Department of Cardiovascular Surgery, ;4.Department of Catheterization Laboratory, Guangdong Provincial People's Hospital & Guangdong Academy of Medical Sciences, Guangzhou, Guangdong 510080, China;5.Guangdong Cardiovascular Institute, Guangzhou, Guangdong 510080, China)

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    摘要:

    目的 分析影响冠心病患者冠状动脉旁路移植术(CABG)近期预后的相关因素,旨在为改善CABG术的效果提供一些依据。方法 收集2019年6月—12月在广东省人民医院心血管外科接受初次CABG手术的65例患者的临床资料,分别比较纳入患者的术前、术中及术后临床指标及手术效果,筛选出可能影响CABG术近期预后的相关因素。结果 纳入接受体外循环CABG术患者55例,非体外循环CABG术(OPCABG)患者10例。年龄高导致CABG术后非正常(死亡和自动出院)出院率增加(P=0.024);OPCABG(P=0.009)、正高职称医师主刀(P=0.027)可减少术后住院时间;同期处理心脏瓣膜可能增加术后并发症的发生(P=0.012);吸烟者术后心功能恢复较慢(P=0.017)。体外循环时间与重症监护病房时间呈正相关(r=0.621,P<0.001)。65例患者中院内死亡1例,死亡率1.54%。结论 年龄、OPCABG、同期处理瓣膜、吸烟、正高职称医师主刀、术前高密度脂蛋白水平和体外循环时间是可能影响冠心病患者CABG近期预后的因素。

    Abstract:

    Aim To analyze the related factors affecting the short-term prognosis of coronary artery bypass grafting (CABG) in patients with coronary heart disease, in order to provide some basis for improving the effect of CABG.Methods The clinical data of 65 patients who underwent the first CABG operation in the department of cardiac surgery of Guangdong Provincial People's Hospital were collected from June to December 2019. The preoperative, intraoperative and postoperative clinical indicators and surgical effects of the included patients were compared, and the related factors that may affect the result of CABG were screened out. Results 55 patients underwent extracorporeal circulation CABG and 10 patients underwent off-pump CABG (OPCABG). High age led to the increase of abnormal (death and automatic) discharge rate after CABG (P=0.024); OPCABG (P=0.009) and high professional doctor (P=0.027) could reduce postoperative hospital stay; Simultaneous treatment of heart valves might increase the incidence of postoperative complications (P=0.012); Smoking could slow down the recovery of cardiac function (P=0.017). The time of cardiopulmonary bypass was positively correlated with the time of intensive care unit (r=0.621, P<0.001). Among the 65 patients, 1 died in hospital, with a mortality rate of 1.54%. Conclusion Age, OPCABG, simultaneous valve management, smoking, operation by senior doctor, preoperative high density lipoprotein level and cardiopulmonary bypass time are the factors influencing the short-term prognosis of CABG in patients with coronary heart disease.

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席悦,王晰朦,刘健,朱平,黄美萍,袁海云.冠心病患者冠状动脉旁路移植术近期预后的影响因素分析[J].中国动脉硬化杂志,2020,28(10):852~855.

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  • 收稿日期:2020-06-12
  • 最后修改日期:2020-09-23
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  • 在线发布日期: 2020-10-20