CAJ | 학술논문

目的筛选冠状动脉旁路移植术患者术后早期体温升高的危险因素.方法择期行冠状动脉旁路移植术患者941例,年龄14 ～ 70岁,性别、身高和体重不限.根据术后8h患者的膀胱温度分为高温组(≥38℃)和常温组(＜38℃).收集患者年龄、性别、身高、体重、合并症(高血压、高血脂、糖尿病)、吸烟史、饮酒史、术前血压、心率、射血分数、血常规检查、尿常规检查、呼吸功能检查、术中体外循环、激素使用情况、手术时间、气管拔管时间、ICU停留时间、术毕血压、心率、血常规检查、尿常规检查和术后镇痛情况.将组间差异有统计学意义的因素进行多因素logistic回归分析,筛选该类患者术后早期体温升高的危险因素.结果 690例患者发生术后早期体温升高,发生率73.3％.l0-gistic回归分析结果显示:术前呼吸功能异常、术前射血分数≤50％和体外循环是冠状动脉旁路移植术患者术后早期体温升高的独立危险因素(P＜0.05).结论术前呼吸功能异常、术前射血分数≤50％和体外循环是冠状动脉旁路移植术患者术后早期体温升高的独立危险因素.
목적 사선관상동맥방로이식술환자술후조기체온승고적위험인소.방법 택기행관상동맥방로이식술환자941례,년령14 ～ 70세,성별、신고화체중불한.근거술후8h환자적방광온도분위고온조(≥38℃)화상온조(＜38℃).수집환자년령、성별、신고、체중、합병증(고혈압、고혈지、당뇨병)、흡연사、음주사、술전혈압、심솔、사혈분수、혈상규검사、뇨상규검사、호흡공능검사、술중체외순배、격소사용정황、수술시간、기관발관시간、ICU정류시간、술필혈압、심솔、혈상규검사、뇨상규검사화술후진통정황.장조간차이유통계학의의적인소진행다인소logistic회귀분석,사선해류환자술후조기체온승고적위험인소.결과 690례환자발생술후조기체온승고,발생솔73.3％.l0-gistic회귀분석결과현시:술전호흡공능이상、술전사혈분수≤50％화체외순배시관상동맥방로이식술환자술후조기체온승고적독립위험인소(P＜0.05).결론 술전호흡공능이상、술전사혈분수≤50％화체외순배시관상동맥방로이식술환자술후조기체온승고적독립위험인소.
Objective To identify the risk factors for early postoperative elevation in body temperature in patients undergoing coronary artery bypass grafting (CABG).Methods Nine hundred and forty-one patients of both sexes,aged 14-70 yr,were assigned into hyperthermia (≥ 38 ℃) group or non-hyperthermia (＜ 38 ℃) group according to the bladder temperature at 8h after operation.Factors including age,sex,height,weight,complications (hypertension,hyperlipemia,diabetes),history of smoking and drinking,preoperative blood pressure,heart rate,ejection fraction,routine blood examination,routine urine examination,and respiratory function examination,intraoperative cardiopulmonary bypass (CPB) and hormone,operation time,extubation time,duration of stay in the intensive care unit,and blood pressure,heart rate,ejection fraction,routine blood examination,and routine urine examination at the end of operation,and postoperative analgesia were recorded.The risk factors of which P values were less than 0.05 would enter the multi-factor logistic regression analysis to stratify the risk factors for early postoperative elevation in body temperature after CABG.Results Six hundred and ninety patients developed early postoperative elevation in body temperature (73.3％).Logistic regression analysis showed that preoperative respiratory dysfunction,preoperative ejection fraction ≤ 50％ and CPB were independent risk factors for early postoperative hyperthermia after CABG (P ＜ 0.05).Conclusion Preoperative respiratory dysfunction,preoperative ejection fraction≤ 50％ and CPB are independent risk factors for early postoperative elevation in body temperature in patients undergoing CABG.