中华临床医师杂志(电子版)
中華臨床醫師雜誌(電子版)
중화림상의사잡지(전자판)
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2015年
4期
555-558
,共4页
王海平%凤玮%姜先雁%吕振乾%刘晓君%张涛
王海平%鳳瑋%薑先雁%呂振乾%劉曉君%張濤
왕해평%봉위%강선안%려진건%류효군%장도
急诊处理%冠状动脉搭桥术%全因死亡率
急診處理%冠狀動脈搭橋術%全因死亡率
급진처리%관상동맥탑교술%전인사망솔
Emergency treatment%Coronary artery bypass grafting%All-cause mortality
目的:比较急诊与择期冠状动脉搭桥两组患者围手术期相关指标,进一步明确急诊手术风险及死亡率。方法回顾分析2011年1月至2013年6月同一术者实施的58例急诊冠状动脉搭桥患者和504例择期冠状动脉搭桥患者的临床资料,比较两组患者相关数据(术前左心室舒张末期直径、左心室射血分数、搭桥数目、术后呼吸机辅助时间、ICU 居住时间、二次开胸止血例数、术后24 h引流量,术后输血量,术后住院天数、术后住院期间死亡率和术后1年全因死亡率)的差别。结果两组患者术前左心室舒张末期直径(P=0.623)、左心室射血分数(P=0.387)、搭桥数目(P=0.423)以及术后一年全因死亡率(P=0.594)比较无显著差别;但术后呼吸机辅助时间(P=0.011)、ICU居住时间(P=0.035)、二次开胸止血(P=0.039)、术后24 h引流量(P=0.000)、术后住院天数(P=0.006)以及术后输血量(P=0.003)上急诊组明显高于对照组。术后住院期间死亡率急诊组高于择期组(P=0.022)。结论急诊组冠状动脉搭桥围手术期风险高于择期组,但两组患者术后1年全因死亡率比较无显著差别。
目的:比較急診與擇期冠狀動脈搭橋兩組患者圍手術期相關指標,進一步明確急診手術風險及死亡率。方法迴顧分析2011年1月至2013年6月同一術者實施的58例急診冠狀動脈搭橋患者和504例擇期冠狀動脈搭橋患者的臨床資料,比較兩組患者相關數據(術前左心室舒張末期直徑、左心室射血分數、搭橋數目、術後呼吸機輔助時間、ICU 居住時間、二次開胸止血例數、術後24 h引流量,術後輸血量,術後住院天數、術後住院期間死亡率和術後1年全因死亡率)的差彆。結果兩組患者術前左心室舒張末期直徑(P=0.623)、左心室射血分數(P=0.387)、搭橋數目(P=0.423)以及術後一年全因死亡率(P=0.594)比較無顯著差彆;但術後呼吸機輔助時間(P=0.011)、ICU居住時間(P=0.035)、二次開胸止血(P=0.039)、術後24 h引流量(P=0.000)、術後住院天數(P=0.006)以及術後輸血量(P=0.003)上急診組明顯高于對照組。術後住院期間死亡率急診組高于擇期組(P=0.022)。結論急診組冠狀動脈搭橋圍手術期風險高于擇期組,但兩組患者術後1年全因死亡率比較無顯著差彆。
목적:비교급진여택기관상동맥탑교량조환자위수술기상관지표,진일보명학급진수술풍험급사망솔。방법회고분석2011년1월지2013년6월동일술자실시적58례급진관상동맥탑교환자화504례택기관상동맥탑교환자적림상자료,비교량조환자상관수거(술전좌심실서장말기직경、좌심실사혈분수、탑교수목、술후호흡궤보조시간、ICU 거주시간、이차개흉지혈례수、술후24 h인류량,술후수혈량,술후주원천수、술후주원기간사망솔화술후1년전인사망솔)적차별。결과량조환자술전좌심실서장말기직경(P=0.623)、좌심실사혈분수(P=0.387)、탑교수목(P=0.423)이급술후일년전인사망솔(P=0.594)비교무현저차별;단술후호흡궤보조시간(P=0.011)、ICU거주시간(P=0.035)、이차개흉지혈(P=0.039)、술후24 h인류량(P=0.000)、술후주원천수(P=0.006)이급술후수혈량(P=0.003)상급진조명현고우대조조。술후주원기간사망솔급진조고우택기조(P=0.022)。결론급진조관상동맥탑교위수술기풍험고우택기조,단량조환자술후1년전인사망솔비교무현저차별。
Objective The clinical data of emergent and selective coronary artery bypass grafting were compared to define the perioperative risks and mortality of emergent operation. Methods To retrospectively analyze 58 patients who underwent emergent coronary artery bypass grafting (ECABG) and 504 patients who underwent selective coronary artery bypass grafting (CABG) performed by same surgeon during Jan, 2011 to Jun, 2013, and to compare the clinical data of two groups. Results Of two groups, no significant difference was found in preoperative left ventricular ejection fraction (LVEF) (P=0.387), left ventricular end-diastolic diameter (LVDD) (P=0.623), bypass grafts (P=0.423) and one year all-cause mortality post operation (P=0.594); But, average ventilator time (P=0.011), intensive care unit stay time (P=0.035), reoperation for bleeding (P=0.039), volume of drainage (P=0.000) and blood transfusion (P=0.003), postoperative in-hospital stay (P=0.006) had significant differences between two groups. The in-hospital mortality was higher in ECABG group (P=0.022). Conclusion The ECABG group was more at perioperative risk, but the all-cause mortality of one year post operation was same in two groups (P=0.594).