心脏术后早期混合静脉血氧饱和度水平的临床研究

Research of mixed venous oxygen saturation after heart operation

目的研究心脏术后早期混合静脉血氧饱和度(SvO2)水平与围术期因素、术后并发症的关系.方法记录95例心脏手术患者术后12 h内的每小时SvO2、心指数(CI).按SvO2均数分为＜60%(Ⅰ组,n=10)、60%～70%(Ⅱ组,n=45)、＞70%(Ⅲ组,n=40)三组.统计各组患者年龄、术前左室射血分数(LVEF)、体外循环时间、主动脉阻断时间(ACT)、ICU停留时间、术前基础疾病和在院期间并发症发生数.结果各组间年龄、LVEF、基础疾病发生数无显著性差异.Ⅰ组的ACT、体外循环时间、ICU停留时间较Ⅱ、Ⅲ组显著延长,CI降低,循环及呼吸系统并发症发生率升高(P＜0.05).结论某些围术期因素可降低心脏术后早期SvO2水平.SvO2水平低时增加并发症的发生率,延长ICU停留时间.

Objective To investigate the relationship between perioperative factors, postoperative complications and different levels of mixed venous oxygen saturation （SvO2） after heart operation. Methods Ninety-five patients after heart operation were divided into three groups according to the means of SvO2〈60% （groupⅠ , n=10）, 60%-70% （groupⅡ, n=45） and〉70%（groupⅢ, n=40）. SvO2 were measured each hour in intensive care unit （ICU） at first twelve hours after operation. Data on age, preoperative ejection fractions （LVEF）, time of cardiopulmonary bypass （CPB）, time of aortic clamped （ACT）, postoperative cardiac index （CI）, length of ICU stay, common coexist diseases and the incidence of inpatient complications were collected prospectively. Results There is no statistically significant difference at age, LVEF and common coexist diseases among three groups. Compared with other two groups, ACT, CPB, length of ICU stay of group Ⅰ were significantly prolonged. CI was decreased, incidence of circulation and respiratory complications in this group were significantly increased（P〈0. 05）. Conclusion Some perioperative factors may decrease the level of postoperative SvO2, which can increase the incidence of complications and prolong ICU stay.