心脏术后高胆红素血症的临床分析

Clinical analysis of hyperbilirubinemia after heart surgery

目的研究心脏术后高胆红素血症的发生率、相关因素及与预后的关系。方法回顾性研究2009年5月～2011年5月266例心脏手术患者术后胆红素的变化趋势及与术前、术中各因素的关系,研究高胆红素血症与预后指标的关系。结果 266例患者心脏手术后有47例出现高胆红素血症,占17.6%,开始时以间接胆红素升高为主,高胆红素血症的发生与术前患者胆红素升高明显相关,并明显延长呼吸机使用时间及监护室治疗时间。结论术后高胆红素血症与术前患者胆红素升高相关,提示与术前肝脏排泄胆红素障碍及心脏手术后胆红素负担加重有关。

Objective To investigate the incidence and the associated factors of postoperative jaundice in patients undergoing cardiac surgery and to analyze the possible mechanism and the relationship with prognosis.Methods A retrospective observational study was conducted on 266 patients who underwent heart surgery from May 2009 to May 2011,evaluated risk factors and prognostic significance of postoperative hyperbilirubinemia were analyzed.Results 47 cases were found postoperative hyperbilirubinemia,the overall incidence was 17.6%,preoperative hyperbilirubinemia was the risk factor associated with postoperative hyperbilirubinemia.Respirator and intensive care time were prolonged by postoperative hyperbilirubinemia.Conclusion Postoperative hyperbilirubinemia is highly associated with preoperative bilirubin concentration,impedence of bilirubin secretion preoperatively and overload of bilirubin after surgery can cause the postoperative hyperbilirubinemia.