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冠脉搭桥论文:冠脉搭桥术后低氧血症相关因素分析

2017-11-14 5页 doc 67KB 32阅读

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冠脉搭桥论文:冠脉搭桥术后低氧血症相关因素分析冠脉搭桥论文:冠脉搭桥术后低氧血症相关因素分析 冠脉搭桥论文:冠脉搭桥术后低氧血症相关因素分析 【中文摘要】低氧血症是冠状动脉搭桥术后的一个严重并发症,是影响冠状动脉搭桥患者术后恢复的关键因素之一。广西的冠状动脉搭桥起步较晚,围术期的管理有待完善和提高,预防和减少冠状动脉搭桥术后的并发症是我们的一项重要任务,尤其是预防术后低氧血症的发生。有效降低冠脉搭桥术后低氧血症的发生将能缩短病人术后呼吸机的使用时间和在重症监护病房的停留时间,促进患者的恢复,减少病人的住院时间及住院费用,更重要的是提高患者术后的生存率以及术后的生活质量...
冠脉搭桥论文:冠脉搭桥术后低氧血症相关因素分析
冠脉搭桥论文:冠脉搭桥术后低氧血症相关因素分析 冠脉搭桥论文:冠脉搭桥术后低氧血症相关因素分析 【中文摘要】低氧血症是冠状动脉搭桥术后的一个严重并发症,是影响冠状动脉搭桥患者术后恢复的关键因素之一。广西的冠状动脉搭桥起步较晚,围术期的管理有待完善和提高,预防和减少冠状动脉搭桥术后的并发症是我们的一项重要任务,尤其是预防术后低氧血症的发生。有效降低冠脉搭桥术后低氧血症的发生将能缩短病人术后呼吸机的使用时间和在重症监护病房的停留时间,促进患者的恢复,减少病人的住院时间及住院费用,更重要的是提高患者术后的生存率以及术后的生活质量。材料与:本研究依据麻醉科心血管手术登记手册上面记载的患者姓名、住院号及手术名称,经统计从1994年到2010年间在我院行冠脉搭桥手术158例。对158例行CABG的患者术后的血气分析结果进行收集,分析CABG患者术后低氧血症的发生与患者年龄、性别、体重、吸烟史、术后拔除气管导管的时间、呼吸道疾病史、高血压病史、糖尿病史、术中的输液总量、术毕的液体余量、术前的EF值、术中出血量、手术时间、麻醉时间、搭桥数、合并瓣膜病病史、合并室壁瘤病史、术前及术后血色素、体外循环时间、升主动脉阻断时间、术前左室大小的关系。采用通用统计学分析处理软件spss16.0对数据进行分析处理。计量资料以均数?差(χ?S)示。初步行单因素分析,符合方差齐性检验的组间资料使用T检验,不合符方差齐性检验的使用近似T检验。计量资料使用Χ2检验。最 后进行观察指标与低氧血症之间的logistics回归分析。检验标准以 a=0.05为显著性检验标准。结果:本研究通过单因素分析发现:年 龄、术毕血色素、拔管时间、术前EF值与术后低氧血症有显著相关 性;通过logistics回归分析发现:性别、吸烟史、瓣膜病、术毕血 色素、拔管时间、麻醉时间、手术时间与术后低氧血症有显著相关性。 结论:1术毕血色素与搭桥术后低氧血症明显相关。术毕血色素越低, 术后出现低氧血症的可能性越大。2女性是搭桥后低氧血症的一个危 险因素3麻醉时间、手术时间与搭桥后低氧血症有关。手术时间越久, 麻醉时间越久,术后出现低氧血症的可能性越大。4瓣膜病、术前EF 值与搭桥后低氧血症有关。术前EF值越低,合并的瓣膜病越严重, 术后出现低氧血症的可能性越大。5拔管时间可以预测搭桥后低氧血 症的发生。术后带管辅助呼吸时间越久,出现低氧血症的可能性越大。 6年龄是搭桥后低氧血症的一个危险因素。年龄越大,术后越容易出 现低氧血症。7糖尿病、高血压、室壁瘤与低氧血症的关系还待进一 步证实。 【英文摘要】:Hypoxemia is a serious complication of coronary arterybypass grafting, it is also one of the key factors affecting the recoveryof patients. Coronary artery bypass started late in Guangxi, theperioperative management needs to be refined and improved. To prevent andreduce the complications of coronary artery bypass grafting is an importanttask, especially to prevent the occurrence of postoperative hypoxemia.Effectively reduce coronary artery bypass grafting hypoxemia will be ableto reduce the use of postoperative ventilator time and residence time in theintensive care unit, to promote the recovery of patients, reduce patientlength of stay and hospitalization costs, and more importantly, is to improvethe quality of life of patients with postoperative survival rate andpostoperative.Materials and Methods: This study, based on manual registration ofcardiovascular surgery operating room anesthesia record above the patient’sname, hospital number and name of statistics to the surgery from 1994 to 2010in our hospital,there is a total of 158 cases of coronary bypass surgery. Routine CABG on 158 patients with postoperative blood gas analysis resultscollected to view, analyze the incidence of postoperative hypoxemia inpatients with CABG and patients age, sex, weight, smoking history,postoperative extubation time, respiratory history, history of hypertension,diabetes mellitus, intraoperative infusion volume, the liquid margin ofsurgery, preoperative EF value, blood loss, operative time, anesthesia time,bridge number, the merger history of valvular disease, ventricular wall tumorhistory, preoperative and postoperative hemoglobin, CPB time, aortic clamptime, preoperative left ventricular size relationship. Statistical analysisusing a common data processing software spss16.0 analysis and processing.Measurement data to mean?standard deviation (S) said. Initial line ofsingle-factor analysis, in line with homogeneity of variance between groupstest data using T-test, not meet the test of homogeneity of variance usingapproximate T-test. Measurement data using the test. Finally, indicators andhypoxemia were observed between the logistics regression analysis. Test witha = 0.05 for the significance test.Results: The study found that by univariate analysis: age, hemoglobinsurgery, extubation time, the value of preoperative EF, aortic clamp timeand postoperative hypoxemia were significantly related; by logisticsregression analysis: gender , history of smoking, valvular disease,hemoglobin of surgery, extubation time, anesthesia time, operative time and postoperative hypoxemia were significantly related.Conclusion::1 bypass surgery and postoperative hemoglobin significantly associatedhypoxemia. Lower hemoglobin surgery, the greater the likelihood ofpostoperative hypoxemia.2 female is a risk factor for hypoxemia3 anesthesia time, operative time are associate with hypoxemia. Longeroperative time, longer anesthesia time,the greater the likelihood ofpostoperative hypoxemia.4 valve disease, preoperative EF are associate with hypoxemia . The lowerpreoperative EF, the more severe valvular disease combined, the greater thelikelihood of postoperative hypoxemia.5 extubation time can predict the occurrence of hypoxemia after CABG. Thelonger postoperative ventilation time , the greater the likelihood ofhypoxemia.6 Age is a risk factor for hypoxemia. Older, more prone to postoperativehypoxemia.7 The relationship between diabetes, hypertension, aneurysm and hypoxemianeed to be further confirmed. 【关键词】冠脉搭桥 低氧血症 【英文关键词】CABG hypoxemia 【目录】冠脉搭桥术后低氧血症相关因素分析 摘要 4-6 ABSTRACT 6-8 前言 9-10 资料与方法 10-12 结果 12-19 讨论 19-24 结论 24 参 考文献 24-26 综述 26-33 参考文献 31-33 致谢 33
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