冠状动脉旁路移植术术前及术中危险因素的探讨-外科学(心胸外科)专业论文.docx

圭堕苎三苎壁查堂!里婴塾塑±鱼圭 圭堕苎三苎壁查堂!里婴塾塑±鱼圭 冠状动脉旁瘁移植术术前及术中危险囡素的攮讨 中变量包括搭桥支数，是否应用乳内动脉，体外循环时间(CPBT)． 以及主动脉阻断时间。术后变量包括：术后心衰，严重切口感染， 呼吸功能不全(呼吸机应用48小时，或需要行气管切开治疗低氧 血症者)，严重肺部感染，术后各种心律失常(包括房颤、室早 等)，以及死亡率。将术前、术中各变量与术后变量心衰、呼吸 功能不全、死亡率、及其术后并发症和死亡数总和进行统计学分 析，从而对得出影响手术效果的术前术中的各危险因素，并给以 理论根据及临床分析。将术前、术中各个变量与术后各变量行 Logistic回归分析。 结果：影响术后心衰发生的因素为心功能(NYHAIII一Ⅳ 级)、年龄、体表面积、术前糖尿病；与呼吸功能不全发生有关 的因素为体外循环时间、术中主动脉阻断时间、年龄；与死亡发 生的有关的因素为术前心功能(NYHAIII--IV级)、体表面积、 左心室射血分数、术前糖尿病、搭桥支数；与术后并发症及其死 亡总和发生有关的因素为术前心绞痛程度(CCSIII--IV级)、术 前糖尿病及术中主动脉阻断时间。 结论：冠心病病人的术前因素(4fl一-LJJ～11匕NYHAIII--Ⅳ级、左 室射血分数、年龄、体表面积、心绞痛CCSIII—IvNN,HuNN 病)及其术中因素(体外循环时间、主动脉阻断时间及搭桥支数) 是冠状动脉旁路手术预后情况的重要影响因素。 圭鱼苎三垦鲎叁兰!旦旦!塾塑主垒圭 圭鱼苎三垦鲎叁兰!旦旦!塾塑主垒圭 墨苎兰查查堡垒垫查查重垒苎!堕生型旦查!型墨苎一 关键词：冠心病；冠状动脉旁路移植术；术后并发症；死亡 率；危险因素 ．3- 圭堕墨苎垦登查堂!!!!墼翌兰兰圭 圭堕墨苎垦登查堂!!!!墼翌兰兰圭 墨竺兰堡壹兰塑苎查查童墨查士垒坠苎查竺墨塑 Investigation of Risk Factors for Coronary Artery Bypass Grafting Abstract objective Coronary artery disease(CAD)is one of common diseases for middle—aged and senile persons．CAD lists ule first mortal cause in Euro-American countries．With the development of economics and improvement of people S standard of living，the incidence of CAD has been increasing in our country．During recent years，CABG has been performed widely in our COLIntry． How to reduce the operative risk and improve post—operation survival rate is the key point for all of cardiac surgeons．To observe the relative risk factors of patients underwent CABG，we designed this retrospective clinical research in order to provide basic data for clinical therapy and prognosis for CAD．The purpose of our study is to assess the predictive risk factors for early morbidity and mortality after coronary artery bypass grafting(CABG)． Methods Data from 1 1 0 consecutive patients who underwent coronary artery bypass grafting in a single center were retrospectively collected．The pre—and intra—operative predictive variables were assessed with Logistic stepwise regresston analysis to Dredict early postoperative morbidity and mortality of th