中国全科医学
中國全科醫學
중국전과의학
CHINESE GENERAL PRACTICE
2015年
24期
2903-2906
,共4页
吴昆鹏%陈莹%言彩红%张凤文%李方%黄治家
吳昆鵬%陳瑩%言綵紅%張鳳文%李方%黃治傢
오곤붕%진형%언채홍%장봉문%리방%황치가
冠状动脉旁路移植术, 非体外循环%体外循环%创伤和损伤
冠狀動脈徬路移植術, 非體外循環%體外循環%創傷和損傷
관상동맥방로이식술, 비체외순배%체외순배%창상화손상
Coronary artery bypass,off-pump%Extracorporeal circulation%Wounds and injuries
目的:比较体外循环及非体外循环冠状动脉旁路移植术后患者急性胃肠功能损伤的发生情况。方法回顾性分析2010年1月—2012年12月南华大学附属第二医院行冠状动脉旁路移植术治疗的冠心病患者536例,根据手术方式分为体外循环组412例,非体外循环组124例。观察两组患者一般情况、基础疾病、超声心动图结果、术后血流动力学、血管活性药物总量、日均尿量,术后急性胃肠功能损伤发生率及急性胃肠功能损伤分级。结果体外循环组与非体外循环组患者性别、年龄、体质量、纽约心脏病学会( NYHA )心功能分级、高血压发生率、糖尿病发生率、高脂血症发生率、慢性阻塞性肺疾病发生率、左心室舒张末期内径、左心室射血分数、术后日均心率、日均动脉压、日均中心静脉压、血管活性药物总量(去甲肾上腺素、多巴胺、多巴酚丁胺、肾上腺素)比较,差异均无统计学意义(P>0.05);体外循环组患者日均尿量较非体外循环组增多(P<0.05)。体外循环组22例(5.3%)发生急性胃肠功能损伤,其中Ⅰ级7例、Ⅱ级13例、Ⅲ级1例、Ⅳ级1例;非体外循环组6例(4.8%)发生急性胃肠功能损伤,均为Ⅰ级。两组患者急性胃肠功能损伤发生率比较,差异无统计学意义(χ2=0.048, P=0.519)。结论体外循环与非体外循环冠状动脉旁路移植术后患者急性胃肠功能损伤发生率无差异,但非体外循环冠状动脉旁路移植术后均为Ⅰ级。
目的:比較體外循環及非體外循環冠狀動脈徬路移植術後患者急性胃腸功能損傷的髮生情況。方法迴顧性分析2010年1月—2012年12月南華大學附屬第二醫院行冠狀動脈徬路移植術治療的冠心病患者536例,根據手術方式分為體外循環組412例,非體外循環組124例。觀察兩組患者一般情況、基礎疾病、超聲心動圖結果、術後血流動力學、血管活性藥物總量、日均尿量,術後急性胃腸功能損傷髮生率及急性胃腸功能損傷分級。結果體外循環組與非體外循環組患者性彆、年齡、體質量、紐約心髒病學會( NYHA )心功能分級、高血壓髮生率、糖尿病髮生率、高脂血癥髮生率、慢性阻塞性肺疾病髮生率、左心室舒張末期內徑、左心室射血分數、術後日均心率、日均動脈壓、日均中心靜脈壓、血管活性藥物總量(去甲腎上腺素、多巴胺、多巴酚丁胺、腎上腺素)比較,差異均無統計學意義(P>0.05);體外循環組患者日均尿量較非體外循環組增多(P<0.05)。體外循環組22例(5.3%)髮生急性胃腸功能損傷,其中Ⅰ級7例、Ⅱ級13例、Ⅲ級1例、Ⅳ級1例;非體外循環組6例(4.8%)髮生急性胃腸功能損傷,均為Ⅰ級。兩組患者急性胃腸功能損傷髮生率比較,差異無統計學意義(χ2=0.048, P=0.519)。結論體外循環與非體外循環冠狀動脈徬路移植術後患者急性胃腸功能損傷髮生率無差異,但非體外循環冠狀動脈徬路移植術後均為Ⅰ級。
목적:비교체외순배급비체외순배관상동맥방로이식술후환자급성위장공능손상적발생정황。방법회고성분석2010년1월—2012년12월남화대학부속제이의원행관상동맥방로이식술치료적관심병환자536례,근거수술방식분위체외순배조412례,비체외순배조124례。관찰량조환자일반정황、기출질병、초성심동도결과、술후혈류동역학、혈관활성약물총량、일균뇨량,술후급성위장공능손상발생솔급급성위장공능손상분급。결과체외순배조여비체외순배조환자성별、년령、체질량、뉴약심장병학회( NYHA )심공능분급、고혈압발생솔、당뇨병발생솔、고지혈증발생솔、만성조새성폐질병발생솔、좌심실서장말기내경、좌심실사혈분수、술후일균심솔、일균동맥압、일균중심정맥압、혈관활성약물총량(거갑신상선소、다파알、다파분정알、신상선소)비교,차이균무통계학의의(P>0.05);체외순배조환자일균뇨량교비체외순배조증다(P<0.05)。체외순배조22례(5.3%)발생급성위장공능손상,기중Ⅰ급7례、Ⅱ급13례、Ⅲ급1례、Ⅳ급1례;비체외순배조6례(4.8%)발생급성위장공능손상,균위Ⅰ급。량조환자급성위장공능손상발생솔비교,차이무통계학의의(χ2=0.048, P=0.519)。결론체외순배여비체외순배관상동맥방로이식술후환자급성위장공능손상발생솔무차이,단비체외순배관상동맥방로이식술후균위Ⅰ급。
Objective To compare the incidence of acute gastrointestinal injury ( AGI) after on -pump and off -pump coronary artery bypass surgery .Methods Conducted a retrospective analysis on 536 patients with coronary heart disease who received coronary artery bypass surgery in the Second Hospital Affiliated to South China University from January 2010 to December 2012.According to surgery method, the patients were divided into two groups: on-pump group (n=412) and off-pump group (n=124) .Observed the general condition, basic diseases, echocardiography results, postoperative hemodynamic index, total amount of vascular active drugs , average daily urine output , and the incidence of postoperative AGI and AGI grading.Results The two groups were not significantly different (P>0.05) in gender, age, body weight, New York heart association ( NYHA ) cardiac function classification , prevalence of hypertension , prevalence of diabetes , prevalence of hyperlipidemia , prevalence of chronic obstructive pulmonary disease , left ventricular end -diastolic diameter , left ventricular ejection fraction, postoperative average daily heart rate , average daily arterial pressure , daily central central venous pressure , total vascular active drugs ( norepinephrine , dopamine , dobutamine , adrenaline ); the on -pump group was higher ( P <0.05) than the off-pump group in average daily urine output.AGI occurred in 22 (5.3%) patients in the on -pump group, among which the number of patients at grade Ⅰ, Ⅱ, ⅢandⅣwas 7, 13, 1 and 1 respectively; AGI occurred in 6 (4.8%) patients in the off -pump group , and all of them were at grade Ⅰ.The two groups were not significantly different in the prevalence of AGI (χ2 =0.048, P =0.519 ) .Conclusion No significant difference exists in the incidence of acute gastrointestinal injury between on -pump coronary artery bypass surgery and off -pump coronary artery bypass surgery , while the cases of acute gastrointestinal injury after off -pump coronary artery bypass surgery are all at grade Ⅰ.