冠状动脉旁路移植术后房颤发生的危险因素调查及防范对策

Risk factors and preventive measures for atrial fibrillation after coronary artery bypass graft

目的对冠状动脉旁路移植术后房颤发生的危险因素进行调查分析,筛选出其危险因素,并提出有效的防范对策,从而为降低CABG术后房颤的发生率提供有利的指导依据。方法调查对象为2006年1月～2012年1月期间来我院行冠状动脉旁路移植术的150例患者,根据术后是否发生AF分为Ⅰ组(术后发生AF)共48例,Ⅱ组102例(术后未发生AF)。结果 CABG术后AF发生率为32.0%(48/150),Ⅰ组年龄≥70岁,合并高血压等疾病,心功能分级Ⅲ级、左心房内径(LAD)≥38 mm,术后未早期应用β受体阻滞剂病例均明显多于Ⅱ组,差异有统计学意义(P<0.05或P<0.01)。高龄(≥70岁)、合并高血压等疾病、LAD≥38 mm、术后早期停用β受体阻滞剂均为CABG术后发生AF的危险因素。结论高龄、左心房内径扩大、合并高血压等疾病、术后早期停用β受体阻滞剂均是CABG后发生AF的危险因素,护理人员应根据上述危险因素采取积极的护理干预措施,从而降低CABG术后房颤的发生。

Objective To investigate and analyze risk factors of coronary artery bypass grafting atrial fibrillation, and pro- pose effective preventive measures, so as to reduce the incidence of CABG atrial fibrillationg. Methods From January 2006 to January 2012 period, 150 patients who underwent coronary artery bypass grafting according to whether postoperative AF occurred divided into Group I （postoperative AF） a total of 48 cases, 102 cases of group II （did not occur after AF）. Results The CABG postoperative AF incidence rate was 32.0% （48/150）, 〉~ 70 years of age, hypertension and other dis- eases; functional class m, left atrial diameter（LAD）≥ 38 mm after surgery was not early application of β-blockers in I group patients were significantly higher than group Ⅲ , the difference was significant（P 〈 0.05 or P 〈 0.01 ）. Old age（ ≥70 years of age）,hypertension and other diseases,the LAD ≥38 mm,early postoperative withdrawal ofβ-blockers were the following CABG AF risk factors. Conclusion Old age,left atrial diameter expansion, hypertension and other diseases, early postoperative withdrawal of 13-blockers are the risk factors of AF after CABG, nurses should take an active nursing inter- ventions based on the risk factors listed above, and thereby reducing the incidence of atrial fibrillation after CABG surgery.