肺动脉高压心脏手术后发生肺高压危象的影响因素分析

【摘要】 目的探讨影响肺动脉高压心脏手术后发生肺高压危象的因素。方法对可能导致肺动脉高压心脏手术后发生肺高压危象的影响因素进行Logistic回归分析。结果 229例肺动脉高压心脏手术患者,术后发生肺高压危象26例,死亡6例,死亡率为23.08%。术前呼吸道感染、术前吸氧、术前使用卡托普利、手术时间、通气频率、再次插管和术后一氧化氮(nitrogen monoxidum,NO)吸入对肺动脉高压患者术后发生肺高压危象具有一定的影响(均P<0.05)。术前呼吸道感染、手术时间和再次插管为肺动脉高压手术后患者发生肺高压危象的危险因素;手术前吸氧、满足通气频率和NO吸入等为保护因素。结论在对肺动脉高压心脏手术后患者的护理过程中,应尽量避免发生危险因素,以及加强保护因素的措施,对术后预防肺高压危象的发生具有重要的意义。更多还原

【Abstract】 Objective To explore the influential factors of pulmonary hypertensive crisis after pulmonary artery hypertension cardiac operation.Method The influential factors of pulmonary hypertensive crisis after pulmonary artery hypertension cardiac operation were analyzed by Logistic regression.Results 229 patients undergoing pulmonary artery hypertension cardiac operation had 26 cases of postoperative pulmonary hypertensive crisis and 6 of them died,with a mortality of 23.08%.Such factors as preoperative infection of respiratory tract,preoperative oxygen inhalation,preoperative use of captopril,operation time,ventilation frequency,re-intubation and preoperative inhalation of nitrogen monoxidum were significant factors of pulmonary hypertensive crisis(all P < 0.05).The preoperative infection of respiratory tract,operation duration and re-intubation were the influential factors of pulmonary hypertensive crisis.Preoperative intermittent inhalation of oxygen,ventilation frequency and right treatment with nitrogen monoxidum were preventive factors.Conclusion During clinical nursing,risk factors should be avoided to enhance preventive factors,which is important for the prevention of preoperative elevation of pulmonary artery pressure as well as of pulmonary hypertensive crisis.更多还原