冠状动脉旁路移植术后呼吸机依赖的危险因素

Risk factors of ventilator dependency after coronary artery bypass grafting

目的:探讨冠状动脉旁路移植术(CABG)后发生呼吸机依赖(VD)的危险因素。方法:选取2007年1月至2007年8月行CABG的140例患者的临床资料进行回顾性分析。结果:本组140例中,发生VD17例(12.14%),年龄≥70岁、合并高血压、心功能Ⅲ级以上、肺动脉高压、术后低心排出量综合征及低白蛋白血症与呼吸机依赖发生关系密切。VD者比非VD者在ICU停留的时间明显延长(P<0.05),病死率明显增加(P<0.01)。结论:VD是CABG术后严重的并发症,可增加ICU停留时间及病死率。加强70岁以上患者的呼吸道管理,合理控制体循环血压及肺动脉压力,积极维护心功能,预防术后低心排出量综合征及低白蛋白血症等,是降低CABG术后发生VD的有效措施。

Objective：To analyze the risk factors of ventilator dependency （VD） after coronary artery bypass grafting （CABG）. Method： One hundred and forty patients underwent CABG from January, 2007 to August, 2007. Both pre-operative and post-operative and post-operative clinical data were collected and analyzed. Result： Among the 140 patients, VD occurred in 17 patients （12.1%）. Elder age （older than 70 years）, high blood pressure, pulmonary artery hypertension, low heart function （heart function of Ⅲ or Ⅳ ）, low cardiac output syndrome and low serum albumin were risk factors of VD. Compared with non-VD patients, patients with VD had longer ICU-stay time （ P 〈 0.05） and higher mortality （ P 〈 0.01 ）. Conclusion：VD remains severe complication after CABG which leads to longer ICU-stay time and higher mortality. Prevention of VD after CABG include： strengthening the respiratory track management in patients older than 70 years, controlling of high blood pressure and pulmonary artery hypertension, improving heart function and preventing low serum albumin.