体重指数对冠状动脉旁路移植术后并发症的影响

Body Mass Index and Postoperative Complications after Coronary Artery Bypass Grafting

目的研究手术前体重指数(BMI)与冠状动脉旁路移植(CABG)术后并发症的关系。方法 99例在福建省立医院接受CABG患者的临床资料。根据术前BMI将患者分成3组,体重正常组21例,体重超重组33例,肥胖组45例,对3组的相关指标进行统计学分析。结果术后住院期间体重超重组死亡1例,死亡率3.03%;肥胖组死亡1例,死亡率4.44%;体重正常组无死亡病例。三组死亡率差异无统计学意义。术后肺部感染发生率肥胖组(24.44%)显著高于体重正常组(4.76%)(P<0.05)。肥胖组切口感染或延期愈合发生率为24.39%,而体重正常组无切口感染或延期愈合的病例(P<0.05)。术后ICU住院天数和术后总住院天数肥胖组高于体重超重组和体重正常组(P<0.05)。术后90 d 6 min步行试验(6MWT)三组间两两比较均有显著性差异,肥胖组明显低于体重超重组和体重正常组(P<0.001)。结论术前高BMI是CABG术后高并发症和运动能力低下的风险因素。

Objective To investigate the relation between body mass index（BMI） and postoperative complications after coronaryartery bypass grafting（CABG）.Methods The clinical data of 99 patients who underwent CABG at Fujian Provincial Hospital were analyzed.The patients were divided into three groups according to their preoperative BMI： normal group（n=21）,overweight group（n=33）,and obese group（n=45）.And the related observation indexes were compared among the 3 groups.Results The hospital mortality of normal,overweight and obese groups were 0%,3.03% and 4.44% respectively（P〉0.05）.The rate of pulmonary infection（24.44%） or wound infection（24.39%） in the obese group was significantly higher than those in the normal group（4.76% or 0%）（P〈0.05）.The time stay ICU or hospital in the obese group were significantly greater than those in the normal and overweight groups（P〈0.05）.6-minute walking test（6MWT） in the obese group was significantly less than that in the normal and overweight groups 3 months after the operation（P〈0.001）.Conclusion High preoperative BMI can take a negative effect on patients after CABG following postoperative complications.