主动脉内球囊反搏辅助非体外循环冠脉搭桥术患者住院死亡的危险因素分析

发布时间：2018-05-19 22:02

本文选题：非体外循环冠状动脉搭桥术 + 主动脉内球囊反搏　；参考：《广西医科大学》2017年硕士论文

【摘要】：目的探讨我院主动脉内球囊反搏辅助非体外循环冠状动脉搭桥术患者住院死亡的危险因素,以期为主动脉内球囊反搏在临床中的应用提供参考。方法对2013年6月至2017年1月在我院行非体外循环冠脉搭桥术(OPCAB)围术期辅助应用主动脉内球囊反搏(IABP)的58例患者资料进行回顾性分析,根据患者在住院期间是否死亡将患者分为存活组和死亡组,采集与比较两组患者的临床资料,包括性别、年龄、术前造影病变血管数、是否合并左主干病变、是否并存高血压、糖尿病、血脂异常与脑卒中等疾病、运用IABP的时机、术中是否紧急转流、术后是否存在器官功能衰竭、是否进行血液透析治疗、术后1周内生化指标的峰值如心肌型肌酸激酶同功酶(CK-MB)、肌酐、脑利钠肽前体(pro-BNP)、总胆红素、肌钙蛋白I及住院时间等相关指标进行多因素回归分析,探讨患者住院死亡的危险因素。结果多因素回归分析显示,术前预防性应用IABP(OR=0.43,P0.05)是患者住院死亡的保护性因素。合并左主干病变(OR=2.509,P0.05)是患者住院死亡的独立危险因素。结论IABP辅助下行OPCAB术的患者,术前预防性应用IABP可降低住院死亡风险,而合并左主干病变住院死亡风险度增高。
[Abstract]:Objective to investigate the risk factors of in-hospital death in patients undergoing non-cardiopulmonary bypass coronary artery bypass (CABG) with intra-aortic balloon counterpulsation (IABP) in order to provide reference for the clinical application of intra-aortic balloon counterpulsation (IABP). Methods from June 2013 to January 2017, 58 patients who underwent off-pump coronary artery bypass grafting (OPCAB) with intraaortic balloon counterpulsation (IABP) during perioperative period were retrospectively analyzed. The patients were divided into survival group and death group according to whether the patient died during hospitalization. The clinical data of the two groups were collected and compared, including sex, age, the number of angiographic lesions before operation, whether the patients were complicated with left main lesion, whether they co-existed with hypertension. Diabetes mellitus, dyslipidemia, stroke and other diseases, the timing of the use of IABP, whether there is an emergency bypass during the operation, whether there is organ failure after the operation, whether to undergo hemodialysis, The peak value of biochemical indexes such as CK-MBN, creatinine, pro-BNPN, total bilirubin, troponin I and hospitalization time were analyzed by multivariate regression analysis within 1 week after the operation, including myocardial creatine kinase isoenzyme, creatinine, brain natriuretic peptide precursor pro-BNPN, total bilirubin, troponin I and hospitalization time. To investigate the risk factors of death in hospital. Results the multivariate regression analysis showed that preoperative prophylactic use of IABP0. 43 (P 0. 05) was the protective factor of death in hospital. The patients with left main lesion were independent risk factors of death in hospital (P 0.05). Conclusion preoperative prophylactic use of IABP can reduce the risk of hospital death in patients with IABP assisted OPCAB surgery, while the risk of hospitalization death with left main lesion is higher.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R614

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