CAJ | 학술논문

目的探讨冠状动脉旁路移植手术(CABG)术后重症监护室(ICU)时间延长的危险因素.方法回顾性分析2006年6月1日至2007年12月31日行CABG手术或CABG合并手术的1623例病人资料.ICU时间延长定义为术后ICU时间≥5天.根据术后ICU时间是否延长将病人分为两组.先对潜在危险因素进行单因素分析,然后将单因素分析有意义的变量纳入logistic回归进行多因素分析.最终确立影响CABG术后ICU时间延长的危险因素,并对分析结果的分辨度和校准度进行检验.结果术后住ICU时间延长51例,占3.14%.logistic多因素分析结果显示:年龄、外周血管疾病、术前危急状态、LVEF、非择期手术、二尖瓣反流、术后呼吸衰竭、术后肾功能衰竭、二次开胸止血为术后ICU时间延长的独立危险因素.结论临床上可根据以上因素预测术后ICU时间,对相应的病人采取更有效的防治措施,有助于缩短术后ICU时间.
목적 탐토관상동맥방로이식수술(CABG)술후중증감호실(ICU)시간연장적위험인소.방법 회고성분석2006년6월1일지2007년12월31일행CABG수술혹CABG합병수술적1623례병인자료.ICU시간연장정의위술후ICU시간≥5천.근거술후ICU시간시부연장장병인분위량조.선대잠재위험인소진행단인소분석,연후장단인소분석유의의적변량납입logistic회귀진행다인소분석.최종학립영향CABG술후ICU시간연장적위험인소,병대분석결과적분변도화교준도진행검험.결과 술후주ICU시간연장51례,점3.14%.logistic다인소분석결과현시:년령、외주혈관질병、술전위급상태、LVEF、비택기수술、이첨판반류、술후호흡쇠갈、술후신공능쇠갈、이차개흉지혈위술후ICU시간연장적독립위험인소.결론 림상상가근거이상인소예측술후ICU시간,대상응적병인채취경유효적방치조시,유조우축단술후ICU시간.
Objective The rate of post -operative complications has been increased with the changes in patients' age,prolonged duration, more severe and diffused lesions, and more patients with complications in recent years. We try to identify the risk factors associated with prolonged stay in the intensive care unit ( ICU ) after coronary artery bypass graft surgery (CABG). Methods 1623 patients who received CABG surgery in Beijing Anzhen Hospital Between June 1, 2006 and December 31,2007 were divided into two groups based on their stay duration in the ICU. Prolonged stay in ICU was defined as 5days or more. Univariate and multivariate analysis ( logistic regression) were used to identify the risk factors. The discrimination and calibration of the result were tested after the risk factors were determined. Results Fifty one patients had prolonged ICU stay, accounting for 3.14% of total cases. Multivariate logistic analysis showed that the age of patients, peripheral vascular diseases, critical status before operation, LVEF, operative status, mitral regurgitation, postoperative respiratory failure,postoperative renal failure, secondary thoracotomy for postoperative bleeding were associated risk factors. Conclusion Prolonged ICU stay after CABG surgery can be predicted based on the above factors. For patients with these risk factors, more pre-and postoperative care strategies are needed.