广西医学
廣西醫學
엄서의학
GUANGXI MEDICAL JOURNAL
2014年
6期
770-772
,共3页
心脏瓣膜疾病%心脏瓣膜置换术%老年%低心排综合征%危险因素
心髒瓣膜疾病%心髒瓣膜置換術%老年%低心排綜閤徵%危險因素
심장판막질병%심장판막치환술%노년%저심배종합정%위험인소
Heart valve disease%Heart valve replacement%Elderly%Low cardiac output syndrome%Risk factor
目的：探讨老年患者心脏瓣膜置换术后发生低心排综合征（ LCOS ）的危险因素。方法行心脏瓣膜置换术的老年患者150例，其中术后发生LCOS 39例（观察组），术后未发生LCOS 111例（对照组）。对患者的相关临床资料行单因素分析确定LCOS的影响因素，再利用非条件logistic回归分析确定LCOS发生的危险因素。结果单因素分析显示，体重指数、合并肾功能不全、心胸比、肺动脉压力、体外循环时间、主动脉循环时间、失血量比、术后心律失常、呼吸机辅助时间、重症监护时间是术后发生LCOS的影响因素（ P均＜0．05）；非条件logistic回归分析结果表明，患者的体重指数＜19 kg／m2、体外循环时间＞100 min、失血量比＞20％、主动脉阻断时间＞60 min为术后发生LCOS的危险因素。结论体重指数＜19 kg／m2、体外循环时间＞100 min、失血量比＞20％、主动脉阻断时间＞60 min为老年患者心脏瓣膜置换术后发生LCOS的危险因素。
目的：探討老年患者心髒瓣膜置換術後髮生低心排綜閤徵（ LCOS ）的危險因素。方法行心髒瓣膜置換術的老年患者150例，其中術後髮生LCOS 39例（觀察組），術後未髮生LCOS 111例（對照組）。對患者的相關臨床資料行單因素分析確定LCOS的影響因素，再利用非條件logistic迴歸分析確定LCOS髮生的危險因素。結果單因素分析顯示，體重指數、閤併腎功能不全、心胸比、肺動脈壓力、體外循環時間、主動脈循環時間、失血量比、術後心律失常、呼吸機輔助時間、重癥鑑護時間是術後髮生LCOS的影響因素（ P均＜0．05）；非條件logistic迴歸分析結果錶明，患者的體重指數＜19 kg／m2、體外循環時間＞100 min、失血量比＞20％、主動脈阻斷時間＞60 min為術後髮生LCOS的危險因素。結論體重指數＜19 kg／m2、體外循環時間＞100 min、失血量比＞20％、主動脈阻斷時間＞60 min為老年患者心髒瓣膜置換術後髮生LCOS的危險因素。
목적：탐토노년환자심장판막치환술후발생저심배종합정（ LCOS ）적위험인소。방법행심장판막치환술적노년환자150례，기중술후발생LCOS 39례（관찰조），술후미발생LCOS 111례（대조조）。대환자적상관림상자료행단인소분석학정LCOS적영향인소，재이용비조건logistic회귀분석학정LCOS발생적위험인소。결과단인소분석현시，체중지수、합병신공능불전、심흉비、폐동맥압력、체외순배시간、주동맥순배시간、실혈량비、술후심률실상、호흡궤보조시간、중증감호시간시술후발생LCOS적영향인소（ P균＜0．05）；비조건logistic회귀분석결과표명，환자적체중지수＜19 kg／m2、체외순배시간＞100 min、실혈량비＞20％、주동맥조단시간＞60 min위술후발생LCOS적위험인소。결론체중지수＜19 kg／m2、체외순배시간＞100 min、실혈량비＞20％、주동맥조단시간＞60 min위노년환자심장판막치환술후발생LCOS적위험인소。
Objective To investigate the risk factors for low cardiac output syndrome ( LCOS) after heart valve replacement in elderly patients .Methods Of 150 elderly patients who underwent heart valve replacement ,39 patients with postoperative LCOS were in the observation group ,111 patients without postoperative LCOS were in the control group .A clinical data of the patients were analyzed by univariate analysis to determine the influence factors for LCOS , and then the risk factors for LCOS were determined by logistic regression analysis .Results Univariate analysis showed that body mass index ,renal insufficiency ,cardiothoracic ratio ,pulmonary arterial pressure (PAP),cardiopulmonary bypass time,aortic clamping time,blood loss ratio,postoperative arrhythmias,ventilation time and intensive care unit stay were the influence factors for postoperative LCOS ( all P<0.05 ) .Unconditional logistic regression analysis showed that patient′s body mass index<19 kg/m2 ,cardiopulmonary bypass time >100 min,blood loss ratio>20%,aortic clamping time>60 minutes were the risk factors for postoperative LCOS .Conclusion Patient′s body mass index<19 kg/m2 , cardiopulmonary bypass time >100 min,blood loss ratio>20%,aortic clamping time>60 min are the risk factors for LCOS in elderly patients undergoing heart valve replacement .
