冠状动脉旁路移植术后心房颤动的相关因素分析

Predictors of Atrial Fibrillation Following Coronary Artery Bypass Grafting Surgery

目的 了解冠状动脉旁路移植术 (CABG)后心房颤动 (Af)的发生率以及相关因素 ,并探讨可能的防治措施。 方法 回顾性地总结了连续 32 2例单纯 CABG病例 ,并将患者分为 Af组和非 Af组。收集术前、术中、术后资料进行统计分析。 结果 CABG术后 Af的发病率为 2 3.3% (75例 ) ,最常见于术后第 1～ 3天。年龄大于 6 5岁、右冠状动脉近 -中段狭窄大于 5 0 %、术后早期未服用β阻滞剂为独立危险因素。 结论 Af是 CABG术后最常见的并发症 ,年龄和右冠状动脉病变可以影响 Af的发生 ,应用β阻滞剂和补充镁可能是预防术后早期 Af发生最经济、有效的方法。

Objective\ To identify the incidence and clinical predictors of atrial fibrillation (Af) after coronary artery bypass grafting(CABG), and to discuss its preventive methods.\ Methods\ Three hundred and twenty two consecutive patients undergoing isolated CABG procedure were reviewed and were grouped according to whether Af appeared. Preoperative, intraoperative and postoperative data were collected and were analysed with statistic methods.\ Results\ The overall incidence of postoperative Af was 23.3%( n=75) . Af after CABG was more common during the first to the third postoperative days. Independent predictors of postoperative Af include age≥65, stenosis>50% in proximal and median segments of right coronary artery, and no administration of β blocker in early postoperative period.\ Conclusion\ Af remains the most common complication after CABG. Age and lesion in right coronary artery can influence the incidence of Af, β blocker and Magnesium may be the most economical and the most effective prevention methods of Af early after CABG.