CAJ | 학술논문

目的：探讨体外循环心脏手术术后并发症的影响因素。方法回顾性分析2009年5月至2013年3月行体外循环心脏手术的203例成年患者的临床资料，分析术后并发症发生情况；根据是否发生术后并发症，将患者分为并发症组和无并发症组，对可能的危险因素进行单因素分析和Logistic多因素回归分析。结果203例患者中，发生术后并发症31例，并发症发生率为15．3％。单因素分析结果显示，年龄大于或等于55岁、体外循环时间大于或等于2 h、主动脉阻断时间大于或等于100 min、心脏功能Ⅳ级以及术前合并原发性高血压、糖尿病、慢性阻塞性肺疾病是诱发术后并发症的相关因素（P＜0．05）。Logistic多因素回归分析结果显示，年龄大于或等于55岁、体外循环时间大于或等于2 h、主动脉阻断时间大于或等于100 min及心脏功能Ⅳ级是导致术后并发症的危险因素（P＜0．05）。结论对于行体外循环心脏手术的患者，应通过术前评估，及时干预可诱发术后并发症的危险因素，从而提高手术安全性和疗效。
목적：탐토체외순배심장수술술후병발증적영향인소。방법회고성분석2009년5월지2013년3월행체외순배심장수술적203례성년환자적림상자료，분석술후병발증발생정황；근거시부발생술후병발증，장환자분위병발증조화무병발증조，대가능적위험인소진행단인소분석화Logistic다인소회귀분석。결과203례환자중，발생술후병발증31례，병발증발생솔위15．3％。단인소분석결과현시，년령대우혹등우55세、체외순배시간대우혹등우2 h、주동맥조단시간대우혹등우100 min、심장공능Ⅳ급이급술전합병원발성고혈압、당뇨병、만성조새성폐질병시유발술후병발증적상관인소（P＜0．05）。Logistic다인소회귀분석결과현시，년령대우혹등우55세、체외순배시간대우혹등우2 h、주동맥조단시간대우혹등우100 min급심장공능Ⅳ급시도치술후병발증적위험인소（P＜0．05）。결론대우행체외순배심장수술적환자，응통과술전평고，급시간예가유발술후병발증적위험인소，종이제고수술안전성화료효。
Objective To investigate risk factors of postoperative complications in cardiac surgery under car-diopulmonary bypass .Methods A total of 203 adult patients undergoing cardiac surgery during May 2009 and March 2013 were enrolled and divided into complication group and non-complication group ,according to the incidence of postoperative complications .Then ,risk factors of postoperative complications were analyzed by using univariate anal-ysis and multivariate Logistic regression analysis .Results In all patients ,31 cases were with postoperative complica-tions ,and the incidence rate was 15 .3% .Univariate analysis indicated that equal with or more than 55 years old ,time of cardiopulmonary bypass equal with or more than 2 h ,time of aortic cross clamping time equal with or more than 100 min ,cardiac function of grade Ⅳ and with preoperative complication of high blood pressure ,diabetes or chronic obstructive pulmonary disease were related influencing factors of postoperative complications (P<0 .05) .Multivari-ate Logistic regression analysis revealed that equal with or more than 55 years old ,time of cardiopulmonary bypass e-qual with or more than 2 h ,time of aortic cross clamping equal with or more than 100 min and cardiac function of grade Ⅳ were independent risk factors of postoperative complications (P<0 .05) .Conclusion For patients undergo-ing cardiac surgery under cardiopulmonary bypass ,preoperative assess should performed to identify and intervene re-lated risk factors of postoperative complications ,so as to improve the operative safety and efficiency .