冠状动脉旁路移植术非体外循环中转体外循环危险因素的评价

Assessment of risk factor undergoing off pump coronary artery bypass graft surgery transfer to on pump

目的:分析与评价冠状动脉旁路移植术非体外循环(OPCAB)术中中转体外循环的危险因素。方法:回顾性分析145例接受OPCAB手术治疗的冠心病患者的临床资料,其中5例中转体外循环。采用不同形式的单因素分析法和多元逐步回归分析,筛选出相关的危险因素。结果:各备选危险因素经单因素分析法的筛选,对符合条件的8个术前危险因素进行logistic回归分析,急性心肌梗死3周内、左主干狭窄度(%)、左室射血分数(LVEF)构成危险因素,其OR分别是18.25,1.029,0.913。结论:OPCAB中转体外循环(ONCAB)相关因素复杂多变,急性心肌梗死内3周、LVEF、左主干狭窄度构成中转的危险因素。但该结果尚有待于大规模多中心的综合评价验证。

Objective： To analyze and assess risk factor of off-pump coronary artery bypass graft surgery transfer to on pump. Methods： 145 consecutive cases of off-pump coronary artery bypass surgery, of which 5 cases transfer to on pump were analyzed retrospectively. Univariate analyses were performed to evaluate the associations between transfer and different selected factors. Significant factors were included in a stepwise logistic regression. Results： In all selected risk factors, operated shorter than 3 weeks after AMI, stenosis of left main branch and LVEF were found to be risk factors of mortality, whose odds rations were18.25, 1.029, 0.913. Conclusion： The risk factors of OPCAB transfer into ONCAB are complexity. A larger scale multiple-center assessment will be required.