摘要
目的探讨心脏瓣膜病换瓣术后住ICU延迟脱离呼吸机的危险因素，为制订心脏瓣膜病换瓣术后住ICU延迟脱离呼吸机的防治措施提供依据。方法采用回顾性病例对照研究和非条件logistic多元回归分析方法，收集宜昌市第一人民医院重症医学科2008年1月至2012年1月心脏瓣膜病换瓣术后的71例患者资料，33例住ICU延迟脱离呼吸机患者与脱呼吸机时间无延迟的38例患者进行对照研究。结果心脏瓣膜病换瓣术后住ICU脱呼吸机时间延迟发生率为46．47％。心脏瓣膜病换瓣术后住ICU延迟脱离呼吸机的危险因素有术后低心排、术后。肾功能衰竭、年龄≥50岁、ST—T改变、住ICU〉5d等。心脏瓣膜病换瓣术后住ICU延迟脱离呼吸机的独立危险因素有：术后低心排（OR=5．329，95％CI1．682-16．881）、术后肾功能衰竭（OR=3．163，95％CI1．007-9．931）。结论心脏瓣膜病换瓣术后住ICU延迟脱离呼吸机的独立危险因素是术后低心排和肾功能衰竭。明确心脏瓣膜病换瓣术后住ICU延迟脱离呼吸机的危险因素，以缩短心脏瓣膜病换瓣术后呼吸机机械通气时间。
Objective To investigate the risk factors of prolonged mechanical ventilation undergoing cardiac valvular surgery in ICU and to provide reference for effective control measure. Methods In order to identify the independent risk factors, 33 cases （January 2008 to January 2012） who had prolonged mechanical ventilation undergoing cardiac valvular surgery were retrospective investigated and multivariable logistic regression was used to analyze the risk factors. Results From January 2008 to January 2012, 71 patients undergoing cardiac valvular surgery were analyzed retrospectively. Among in them, 33 caseas had prolonged mechanical ventilation undergoing cardiac valvular surgery, the morbidity rate was 46.47%. Univariate analysis of risk factors for prolonged mechanical ventilation undergoing cardiac valvular surgery were postoperative low cardiac output syndrome, postoperative renal failure, age t〉50 years, ST-T change and postoperative prolonged stay in ICU〉5 d compared with the control patients. The independent risk factors of prolonged mechanical ventilation undergoing cardiac valvular surgery were postoperative low cardiac output syndrome （OR=5.329, 95% CI 1.682-16.881 ）, postoperative renal failure （0R=3.163, 95% CI 1.007-9.931 ）. Conclusion The independent risk factors of prolonged mechanical ventilation undergoing cardiac valvular surgery are postoperative low cardiac output syndrome, postoperative renal failure.
出处
《中国心血管病研究》
CAS
2013年第2期131-134,160,共5页
Chinese Journal of Cardiovascular Research
