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冠状动脉旁路移植术后延迟脱呼吸机时间的危险因素

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2013年第4期
页码:
430-432435
栏目:
临床研究
出版日期:
2013-07-25

文章信息/Info

Title:
Case/control study of prolonged mechanical ventilation following coronary artery bypass grafting in ICU
作者:
伍育旗1; 余 旻1; 井 景2; 钱 民1; 于 超1; 黄睿1; 郭昌云1
(三峡大学人民医院、宜昌市第一人民医院：1.重症医学科，2.心内科，湖北 宜昌 443002)
Author(s):
WU Yuqi1;  YU Min1;  JING Jing2;  QIAN Min1;  YU Chao1;  HUANG Rui1;  GUO Changyun1
(1.ICU, 2.Department of Cardiology, People’s Hospital, Three Gorge University, First People’s Hospital of Yichang City, Yichang 443000, Hubei, China)
关键词:
冠状动脉旁路移植术; 延迟脱呼吸机; 病例对照研究; 危险因素
Keywords:
prolonged mechanical ventilation;  coronary artery bypass grafting;  case/cohort study;  risk factors
分类号:
R181.32
DOI:
-
文献标识码:
A
摘要:
目的:探讨冠状动脉旁路移植术(CABG)后脱呼吸机时间延迟的危险因素。方法：采用病例对照研究方法，取宜昌市第一人民医院重症医学科2008年1月~2012年1月CABG后的临床资料完整全部病例患者为研究对象，脱呼吸机时间延迟病例为病例组(15例)，取同期同科室的CABG后脱呼吸机时间无延迟者为对照组（53例）。结果：CABG后脱呼吸机时间延迟单因素分析结果：术后低心排、术后循环衰竭、术后肾功衰竭、慢性阻塞性肺部疾病（COPD）、糖尿病、术后住ICU时间延迟。脱机时间延迟的独立的危险因素是: 术后低心排［OR 33.85，OR95.0%CI (1.61-711.35)］；术后肾功衰竭［OR 6.98，OR95.0%CI(1.00-48.56］；COPD［OR 12.35，OR95.0%CI(1.09-139.35)］ (均P<0.05)。结论：CABG后脱呼吸机时间延迟独立的危险因素是: 术后低心排、术后肾功衰竭、COPD。
Abstract:
AIM:To explore the risk factors of prolonged mechanical ventilation (MV) following coronary artery bypass grafting in intensive care unit (ICU). METHODS: We conducted a retrospective case/control study for independent risk factors using multivariable logistic regression analysis in 68 patients treated with or without prolonged MV in ICU following coronary artery bypass grafting (CABG). RESULTS: Of the 68 patients, 15 patients were treated with prolonged MV following CABG and 53 cases without prolonged MV; the morbidity rate was 2205%. Univariate analysis showed that risk factors of prolonged MV following CABG were postoperative low cardiac output syndrome, postoperative circulation failure, postoperative renal failure, chronic obstructive pulmonary disease (COPD), diabetes and prolonged postoperative stay in ICU. Compared with those in control patients, the independent risk factors of prolonged MV following CABG were postoperative low cardiac output syndrome (OR 33854, 95% CI: 161-71135), postoperative renal failure (OR 698, 95% CI: 100-4856), and COPD (OR 1235, 95% CI: 109-13935) (P<005). CONCLUSION: The independent risk factors of prolonged MV following CABG are postoperative low cardiac output syndrome, postoperative renal failure and COPD.

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备注/Memo

备注/Memo:
收稿日期：2012-11-27.作者简介：伍育旗，副主任医师 Email：wu926@163.com
更新日期/Last Update: 2013-07-29