非体外循环冠状动脉旁路移植术后低氧血症相关因素分析

Clinical research on hypoxemia in patients after Off-pump coronary artery bypass grafting

目的:分析非体外循环冠状动脉旁路移植术(off-pump coronary artery bypass,OPCABG)后,低氧血症发生的相关因素并探讨预防及处理措施。方法:143例OPCABG患者,术后发生低氧血症40例,对低氧血症患者的年龄、体质量、术前心功能状态、不良习惯、手术时间、术中输液量、尿量、出血量、术中及术后输血量与非低氧血症患者之间,进行相关危险因素分析。结果:低氧血症患者与非低氧血症患者之间,在体质量、术前是否吸烟、手术时间、术中输液量及术后输血量之间,存在明显差异,所有低氧血症患者,在应用利尿、抗感染、呼吸末正压通气、延长机械通气时间治疗后好转,未出现死亡病例。结论:OPCABG术后,低氧血症易发生在体质量大、术前抽烟、手术时间长及术中输液量多的患者,应用抗感染、利尿、加用呼吸末正压等治疗后可纠正低氧血症。

Objective：To analyze the relative factors of hypoxemia undergoing off-pump coronary artery bypass grafting and discuss the Prevention and treatment of hypoxemia.Methods：Among the 143 patients investigated,40 patients suffered hypoxemia after operation,And relative factors of age,weight,smoking,operation-time,urine quantity,bleeding quantity,blood transfusion quantity were analysised during the two groups.Results：There was significant difference among the two groups in weight,somoking,operation-time,urine quantity,bleeding quantity,blood transfusion quantity.All the cases were successfully corrected with diuresis,anti-infection,PEEP,prolonged ventilation treatment.Conclusion：Hypoxemia after OPCABG is proved to occurred in patients with high weight,pre-operation smoking,longer-operation time,superabundant liquid transfusion during operation,and can be corrected with diuresis,anti-infection,PEEP,prolonged ventilation treatment.