体外循环下成人心脏手术围手术期出血危险因素分析

发布时间：2018-01-01 11:11

  本文关键词：体外循环下成人心脏手术围手术期出血危险因素分析　出处：《宁夏医科大学》2016年硕士论文　论文类型：学位论文

  更多相关文章： 体外循环 心脏手术 出血 危险因素

【摘要】：目的:筛选体外循环(Cardiopulmonary bypass,CPB)下成人心脏手术围手术期出血的危险因素。方法:收集宁夏医科大学总医院心脏大血管外科自2012年1月-2014年12月体外循环下成人心脏手术患者的临床资料作为研究对象;查阅文献后确定与围手术期出血相关的潜在危险因素;将所有研究对象共计570例分为两组,出血组(68例)及非出血组(502例);对潜在危险因素进行单因素分析和logistic多因素回归分析,从而筛选出围手术期出血的危险因素。结果:纳入研究对象共计570例,其中发生围手术期出血的共计68例,经单因素分析发现围手术期出血的危险因素为:CPB转流时间≥120min(P=0.000)、手术类型(P=0.000)、术前心功能(NYHA)分级≥III级(P=0.000)、是否使用止血药物(P=0.000)、止血药物类型(P=0.000)、术前Hct水平(P=0.004)、BMI(P=0.013)、年龄(P=0.048)。经Logistic多因素回归分析显示,CPB转流时间、心功能分级、是否使用止血药物、手术类型及BMI为我院围手术期出血的独立危险因素。结论:1.在行体外循环心脏手术的患者中,CPB转流时间、心功能分级、是否使用止血药物、手术类型及BMI均为围手术期出血的独立危险因素。2.本研究为单中心研究,样本量较小,临床数据存在部分缺失,对研究的最终结果可能会产生一定的影响,讨论不够全面,仍需长期观察并验证。
[Abstract]:Objective: to screen cardiopulmonary bypass during cardiopulmonary bypass (CPB). CPB). Risk factors of perioperative bleeding in adult patients undergoing cardiac surgery. Methods:. The clinical data of adult patients undergoing cardiopulmonary bypass from January 2012 to December 2014 in the Department of Cardiovascular surgery in the General Hospital of Ningxia Medical University were collected as the research objects. The potential risk factors associated with perioperative hemorrhage were identified after literature review. A total of 570 cases were divided into two groups: 68 cases of bleeding group (n = 68) and 502 cases of non-bleeding group (n = 502). The risk factors of perioperative bleeding were screened by univariate analysis and logistic multivariate regression analysis. Results: a total of 570 patients were included in the study. A total of 68 cases of perioperative bleeding were found. The risk factors of perioperative bleeding were found to be 鈮，

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