【摘要】 目的：探讨二尖瓣狭窄(MS)患者外科术后早期预后影响因素。方法：回顾性分析诊断为MS并行外科手术治疗的患者173例的临床资料，将ICU滞留时间视为术后早期预后的观察指标，按照ICU滞留时间分为延迟组(≥72 h)38例和非延迟组(<72 h)135例。收集患者临床资料，行单因素和多因素Logistic回归分析，探讨影响MS患者早期预后的影响因素。结果：单因素分析显示体重、体重指数(BMI)、肺动脉高压程度、左心室舒张末期内径、心房手术、二次气管插管、心力衰竭或血流动力学不稳定、持续肾脏替代治疗(CRRT)、主动脉球囊反搏(IABP)、体外膜肺氧合(ECMO)、肺部感染、心肺复苏、血管活性药物指数评分(VIS)、手术时长、体外循环时间、主动脉阻断时间等因素与ICU滞留时间延长相关。多因素回归分析显示体重、BMI、左心室舒张末期内径、左心房收缩末期内径、心力衰竭或血流动力学不稳定、肺部感染及手术时长等为ICU滞留时间延长的独立危险因素。结论：MS患者体重、BMI、左心室舒张末期内径、左心房收缩末期内径、心力衰竭或血流动力学不稳定、肺部感染及手术时长等为影响外科术后早期预后的主要因素。更多还原

【Abstract】 Objective To investigate the early prognostic factors in patients with mitral stenosis(MS) after surgery. Method Retrospective analysis was made on 173 patients with MS and treated by surgery. The retention time in ICU was regarded as an observation index of early postoperative prognosis, and According to the detention time in ICU, 38 cases were divided into delayed group(≥72 h) and 135 cases were divided into non-delayed group(<72 h). The clinical data of patients were collected, and the influencing factors were analyzed by single factor and multi factor logistic regression. Exploring the influencing factors of early prognosis in MS patients.Results Univariate analysis showed that body weight, BMI, degree of pulmonary hypertension, left ventricular end diastolic diameter, atrial surgery, secondary endotracheal intubation, heart failure or hemodynamic instability, CRRT, IABP, ECMO, pulmonary infection, cardiopulmonary resuscitation, vasoactive drug index score, hand operation duration, cardiopulmonary bypass duration, aortic occlusion duration and other factors were associated with prolonged ICU stay. Multivariate regression analysis showed that body weight, BMI, left ventricular end diastolic diameter, left atrial end systolic diameter, heart failure or hemodynamic instability, pulmonary infection and operation duration were independent risk factors for prolonged ICU stay. Conclusion Body weight, BMI, left ventricular end diastolic diameter, left atrial end systolic diameter, heart failure or hemodynamic instability, pulmonary infection and operation duration of patients with mitral stenosis are the main factors that affect the early prognosis after surgery, which requires special attention in clinical practice.更多还原