中华老年医学杂志
中華老年醫學雜誌
중화노년의학잡지
Chinese Journal of Geriatrics
2013年
4期
386-389
,共4页
陈定柱%张奕%朱元佑%刘进平%沈斐敏
陳定柱%張奕%硃元祐%劉進平%瀋斐敏
진정주%장혁%주원우%류진평%침비민
心脏外科手术%体外循环%手术后并发症%危险因素
心髒外科手術%體外循環%手術後併髮癥%危險因素
심장외과수술%체외순배%수술후병발증%위험인소
Cardiac surgical procedures%Extracorporeal circulation%Postoperative complications%Risk factors
目的 分析老年患者体外循环下心脏外科围术期并发症及危险因素. 方法 我科自2004年7月至201 2年6月共为64例年龄≥60岁的老年患者施行体外循环下心脏手术,通过收集患者相关临床资料,采用单因素及多因素Logistic回归方法分析老年患者体外循环下心脏外科围术期常见并发症及危险因素. 结果 本组患者术后并发症发生率34.4％ (22/64),发生并发症例次42例次,早期手术死亡4例,手术死亡率6.3％.单因素分析显示,术前合并慢性阻塞性肺疾病(p=0.001)、术前合并糖尿病(P=0.009)、体外循环时间≥2 h(P=0.000)、主动脉阻断时间≥90 min(P=0.001)、输血量≥2000 ml(P=0.000)是老年患者体外循环下心脏手术后出现并发症的危险因素.多因素Logistic回归分析示术前合并慢性阻塞性肺疾病(P=0.007)、术前合并糖尿病(P=0.028)、体外循环时间≥2 h (P=0.003)、输血量≥2000 ml(P=0.030)是老年患者体外循环下心脏手术后出现并发症的独立危险因素. 结论 术前合并慢性阻塞性肺疾病、糖尿病、体外循环时间≥2h、输血量≥2000ml是老年患者体外循环下心脏手术后出现并发症的独立危险因素.
目的 分析老年患者體外循環下心髒外科圍術期併髮癥及危險因素. 方法 我科自2004年7月至201 2年6月共為64例年齡≥60歲的老年患者施行體外循環下心髒手術,通過收集患者相關臨床資料,採用單因素及多因素Logistic迴歸方法分析老年患者體外循環下心髒外科圍術期常見併髮癥及危險因素. 結果 本組患者術後併髮癥髮生率34.4％ (22/64),髮生併髮癥例次42例次,早期手術死亡4例,手術死亡率6.3％.單因素分析顯示,術前閤併慢性阻塞性肺疾病(p=0.001)、術前閤併糖尿病(P=0.009)、體外循環時間≥2 h(P=0.000)、主動脈阻斷時間≥90 min(P=0.001)、輸血量≥2000 ml(P=0.000)是老年患者體外循環下心髒手術後齣現併髮癥的危險因素.多因素Logistic迴歸分析示術前閤併慢性阻塞性肺疾病(P=0.007)、術前閤併糖尿病(P=0.028)、體外循環時間≥2 h (P=0.003)、輸血量≥2000 ml(P=0.030)是老年患者體外循環下心髒手術後齣現併髮癥的獨立危險因素. 結論 術前閤併慢性阻塞性肺疾病、糖尿病、體外循環時間≥2h、輸血量≥2000ml是老年患者體外循環下心髒手術後齣現併髮癥的獨立危險因素.
목적 분석노년환자체외순배하심장외과위술기병발증급위험인소. 방법 아과자2004년7월지201 2년6월공위64례년령≥60세적노년환자시행체외순배하심장수술,통과수집환자상관림상자료,채용단인소급다인소Logistic회귀방법분석노년환자체외순배하심장외과위술기상견병발증급위험인소. 결과 본조환자술후병발증발생솔34.4％ (22/64),발생병발증례차42례차,조기수술사망4례,수술사망솔6.3％.단인소분석현시,술전합병만성조새성폐질병(p=0.001)、술전합병당뇨병(P=0.009)、체외순배시간≥2 h(P=0.000)、주동맥조단시간≥90 min(P=0.001)、수혈량≥2000 ml(P=0.000)시노년환자체외순배하심장수술후출현병발증적위험인소.다인소Logistic회귀분석시술전합병만성조새성폐질병(P=0.007)、술전합병당뇨병(P=0.028)、체외순배시간≥2 h (P=0.003)、수혈량≥2000 ml(P=0.030)시노년환자체외순배하심장수술후출현병발증적독립위험인소. 결론 술전합병만성조새성폐질병、당뇨병、체외순배시간≥2h、수혈량≥2000ml시노년환자체외순배하심장수술후출현병발증적독립위험인소.
Objective To analyze the risk factors for complications in elderly patients with cardiac surgery under cardiopulmonary bypass.Methods From July 2004 to June 2012,64 patients aged ≥ 60 years undergoing cardiac operations were selected.Clinical data were collected.The complications after cardiac operation and the risk factors were evaluated by single factor analysis and multivariate Logistic regression analysis with SPSS software.Results The postoperative complication rate in all patients was 34.4％ (22/64).The complications occurred in 42 subjects and operative mortality was 6.3％ (4/64).The single factor analysis showed that chronic obstructive pulmonary disease combined before operation (P=0.001),diabetes combined before operation (P=0.009),cardiopulmonary bypass time ≥2 h (P=0.000),aortic cross clamping time ≥90min (P=0.001),and blood transfusion volume ≥2000 ml (P =0.000) were the important risk factors for postoperative complications.Multivariate Logistic regression analysis revealed that chronic obstructive pulmonary disease (P=0.007) and diabetes combined before operation (P=0.028),cardiopulmonary bypass time ≥2 h (P=0.003),and blood transfusion volume ≥2000 ml (P=0.030) were the significant independent predictive risk factors for postoperative complications.Conclusions Chronic obstructive pulmonary disease,diabetes,cardiopulmonary bypass time ≥2 h,aortic cross clamping time ≥90 min,and blood transfusion volume ≥2000 ml are the independent predictive risk factors for postoperative complications in elderly patients with cardiac surgery under cardiopulmonary bypass.
