心包剥脱术围术期危险因素与转归分析
发布时间：2018-12-31 17:56
【摘要】：目的本研究旨在分析影响心包剥脱术短期及长期转归的围术期危险因素。方法回顾自2009年3月至2014年7月在阜外心血管病医院进行心包剥脱术的95个病例,收集患者的术前、术中及术后数据。通过电话随访患者术后长期转归。利用t检验、卡方检验及Kaplan-Meier等方法检验危险因素与转归是否存在联系。结果入组95例,随访83例(87.4%),平均年龄42.26±14.49岁,男性68人(71.5%)。术后30天内21名患者出现并发症(22.1%),3名患者死亡(3.2%)。随访中1名患者病死。统计学分析显示影响心包剥脱术术后短期并发症的危险因素包括：心包炎病因(P=0.035)、伴随其它心脏手术(P=0.022)、术前NYHA分级(P=0.026)、体外循环(P=0.001)、术终高糖血症(P=0.016)。预测术后短期并发症的最佳术终血糖截断值是7.36mmol/L(敏感度50%,特异度78.7%)。Kaplan-Meier法显示影响长期转归的危险因素包括心包炎病因(P=0.024)、心功能分级(P=0.013)、ASA分级(P=0.005)、术后并发症(P=0.013)、术后低心排综合征(P=0.014)及术终血糖7.36mmool/L(P=0.012)。多因素分析显示术前心功能分级可作为预测术后长期转归的的独立危险因素(HR 3.985,95%CI 1.852-8.573,P=0.000)。结论心脏手术后心包炎、术前NYHA Ⅳ级、术终高糖血症(7.36mmol/L)影响患者术后短期及长期转归。此外,伴随其它心脏手术及体外循环与术后短期并发症发生相关。ASA分级、术后并发症及术后低心排综合症与长期转归相关。本研究为心包剥脱术围术期管理提供临床依据。
[Abstract]:Objective to analyze the perioperative risk factors influencing the short-and long-term outcome of pericardiectomy. Methods from March 2009 to July 2014, 95 patients who underwent pericardiectomy in Fuwei Cardiovascular Hospital were reviewed and the data were collected before, during and after operation. Patients were followed up by telephone for a long time after operation. T test, chi-square test and Kaplan-Meier were used to test the relationship between risk factors and outcome. Results there were 95 cases in the group, 83 cases (87.4%) were followed up, the average age was 42.26 卤14.49 years old, 68 cases (71.5%) were male. Complications occurred in 21 patients (22.1%) and death in 3 patients (3.2%) 30 days after operation. One patient died during follow-up. Statistical analysis showed that the risk factors for short-term complications after pericardiectomy included pericarditis (P0. 035), other cardiac surgery (P0. 022), preoperative NYHA grade (P0. 026), cardiopulmonary bypass (P0. 001). Postoperative hyperglycemia (P0. 016). The best end blood glucose cut-off value for predicting short-term postoperative complications was 7.36mmol/L (sensitivity 50%, specificity 78.7%). The risk factors affecting long-term outcome were revealed by Kaplan-Meier method, including pericarditis (P0. 024). Cardiac function grading (P0. 013), ASA), postoperative complications (P0. 013), postoperative low cardiac output syndrome (P0. 014) and postoperative blood glucose 7.36mmool/L (P0. 012). Multivariate analysis showed that preoperative cardiac function grading could be used as an independent risk factor to predict long-term postoperative outcome (HR 3.98595 CI 1.852-8.573P0. 000). Conclusion pericarditis after cardiac surgery, preoperative NYHA grade 鈪，
本文编号：2396919
[Abstract]:Objective to analyze the perioperative risk factors influencing the short-and long-term outcome of pericardiectomy. Methods from March 2009 to July 2014, 95 patients who underwent pericardiectomy in Fuwei Cardiovascular Hospital were reviewed and the data were collected before, during and after operation. Patients were followed up by telephone for a long time after operation. T test, chi-square test and Kaplan-Meier were used to test the relationship between risk factors and outcome. Results there were 95 cases in the group, 83 cases (87.4%) were followed up, the average age was 42.26 卤14.49 years old, 68 cases (71.5%) were male. Complications occurred in 21 patients (22.1%) and death in 3 patients (3.2%) 30 days after operation. One patient died during follow-up. Statistical analysis showed that the risk factors for short-term complications after pericardiectomy included pericarditis (P0. 035), other cardiac surgery (P0. 022), preoperative NYHA grade (P0. 026), cardiopulmonary bypass (P0. 001). Postoperative hyperglycemia (P0. 016). The best end blood glucose cut-off value for predicting short-term postoperative complications was 7.36mmol/L (sensitivity 50%, specificity 78.7%). The risk factors affecting long-term outcome were revealed by Kaplan-Meier method, including pericarditis (P0. 024). Cardiac function grading (P0. 013), ASA), postoperative complications (P0. 013), postoperative low cardiac output syndrome (P0. 014) and postoperative blood glucose 7.36mmool/L (P0. 012). Multivariate analysis showed that preoperative cardiac function grading could be used as an independent risk factor to predict long-term postoperative outcome (HR 3.98595 CI 1.852-8.573P0. 000). Conclusion pericarditis after cardiac surgery, preoperative NYHA grade 鈪，
本文编号：2396919
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