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冠状动脉旁路移植术后低氧血症的相关因素分析

Risk factors of postoperative hypoxemia in patients undergoing coronary artery bypass grafting

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【作者】 冯靖季强梅运清王玺胜蔡建志

【Author】 FENG Jing,JI Qiang,MEI Yun-qing,WANG Xi-sheng,CAI Jian-zhi(Dept.of Thoracic Cardiovascular Surgery,Tongji Hospital,Tongji University,Shanghai 200065,China)

【机构】 同济大学附属同济医院心胸外科

【摘要】 目的探讨冠状动脉旁路移植术(coronary artery bypasses grafting,CABG)后发生低氧血症的相关危险因素。方法对2007年1月至2009年6月接受单纯CABG的患者共288例的术前、术中、术后资料进行回顾性分析。将CABG术后在机械通气(FiO2>45%)或面罩加鼻导管供氧(氧流量6 L/min)条件下,PaO2低于[102-(0.33×年龄)]mmHg者,确诊为低氧血症。结果 288例CABG患者中,78例(27.08%)发生术后低氧血症。CABG术后发生低氧血症的独立危险因素有:术前慢性阻塞性肺部疾病史(OR=8.531,95%CI 3.136~23.210)、术前急性心肌梗死史(OR=3.351,95%CI 1.539~7.296)、术前糖尿病(OR=3.108,95%CI 1.439~6.713)。结论慢性阻塞性肺部疾病史、术前急性心肌梗死史、术前糖尿病是CABG术后发生低氧血症的3个独立危险因素。

【Abstract】 Objective To investigate the risk factors of postoperative hypoxemia in patients undergoing coronary artery bypass grafting(CABG).Methods Two hundred and eighty eight patients received CABG from January 2007 to June 2009 in our hospital.Mechanical ventilation(FiO2 over 45%) or mask oxygen supply(over 6L/min)was administrated following CABG;PaO2less than[102-(0.33×age)]mmHg was diagnosed as postoperative hypoxemia.The relative factors of postoperative hypoxemia were tested through descriptive analysis and logistic regression.Results The incidence rate of postoperative hypoxemia in this series was 27.08%.According to descriptive analysis and logistic regression,the independent risk factors of postoperative hypoxemia were as follows: underlying chronic pulmonary diseases(OR=8.531,95%CI 3.136-23.210),preoperative acute myocardial infarction(OR=3.351,95%CI 1.539-7.296),diabetes(OR=3.108,95%CI 1.439-6.713).Conclusion Chronic pulmonary diseases,acute myocardial infarction and diabetes are independent risk factors for postoperative hypoxemia following CABG.

  • 【文献出处】 同济大学学报(医学版) ,Journal of Tongji University(Medical Science) , 编辑部邮箱 ,2012年05期
  • 【分类号】R654.2
  • 【被引频次】17
  • 【下载频次】133
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