非体外循环下冠状动脉旁路移植术术后死亡原因分析

发布时间：2018-07-27 21:02

【摘要】：目的探讨非体外循环下冠状动脉旁路移植术术后死亡患者的临床特点及死亡原因分析。方法收集宁夏医科大学总医院心脏大血管外科行非体外循环下冠状动脉旁路移植术治疗的患者的临床资料作为研究对象,确定潜在相关的危险因素,从其临床资料中收集数据,对影响手术死亡的危险因索进行单因素分析和logistic多因素回归分析,探究施行非体外循环下冠状动脉旁路移植术术后死亡患者的临床特点,并分析我院冠状动脉旁路移植术术后死亡的相关危险因素。结果收集整理我院行非体外循环下冠状动脉旁路移植术治疗患者437例,死亡14例,手术死亡率3.20%(14/437),手术死亡患者平均年龄(62.7±2.7)岁,死亡患者男:女=9:5。单因素分析与患者术后死亡的危险因素:术前合并脑梗塞病史、肾功能不全、术前心功能(NYHA)分级≥III级、合并三尖瓣关闭不全病史、左心室射血分数(LVEF)50%、术后的恶性心律失常(室颤)、术后切口感染、术后肺感染、术后低心排综合征、术后桥血管出血、术后肾功能衰竭、术后呼吸衰竭、术后多脏器衰竭。经Logistic多因素回归分析显示,术后患者死亡的独立危险因素为:术后呼吸衰竭、左心室射血分数(LVEF)50%。结论1、患者术前合并脑梗塞病史、肾功能不全、术前心功能(NYHA)分级≥III级、合并三尖瓣关闭不全病史、左心室射血分数(LVEF)50%、术后的恶性心律失常(室颤)、术后切口感染、术后肺感染、术后低心排综合征、术后桥血管出血、术后肾功能衰竭、术后呼吸衰竭、术后多脏器衰竭等为非体外循环下冠状动脉旁路移植术术后死亡的危险因素,可以评估非体外循环下冠状动脉旁路移植术的住院死亡风险;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,对最终结果可能会产生一定的影响,扩大本文研究样本量及长期观察并验证,对于进一步明确患者术后死亡危险因素具有重要的临床意义。
[Abstract]:Objective to investigate the clinical features and causes of death after off-pump coronary artery bypass grafting (CABG). Methods the clinical data of patients undergoing off-pump coronary artery bypass grafting (CABG) in cardiac macrovascular surgery department of Ningxia Medical University General Hospital were collected as study subjects to identify potential risk factors and collect data from their clinical data. Univariate analysis and logistic multivariate regression analysis were performed to investigate the clinical characteristics of patients who died after off-pump coronary artery bypass grafting (CABG). The risk factors of death after coronary artery bypass grafting in our hospital were analyzed. Results 437 patients underwent off-pump coronary artery bypass grafting in our hospital, 14 patients died. The operative mortality rate was 3.20% (14 / 437). The average age of the patients died was (62.7 卤2.7) years. Univariate analysis and risk factors of death after operation: preoperative history of cerebral infarction, renal insufficiency, preoperative (NYHA) grade 鈮，

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