体外循环心脏手术后胸腔积液发生率及危险因素分析

Analysis of risk factors for pleural effusions after cardiac surgery with cardiopulmonary bypass

目的研究心脏外科体外循环心脏手术后胸腔积液发生率，并分析其相关危险因素。方法选取2012年4月至2013年10月在北京协和医院心外科接受体外循环下心脏手术的患者173例，符合纳入标准的患者共136例，其中男性90例，女性46例。统计患者术前基本信息、术前用药、术前术后化验指标、术前并发症，应用SPSS16．0统计分析软件对统计结果进行分析。结果136例患者中53例手术后发生胸腔积液，发生率为39％。患者术前心功能、房颤、周围血管病，术前应用抗凝药、氯吡格雷、ACEI、抗心律失常药是心脏手术后胸腔积液发生的危险因素。结论体外循环心脏手术后胸腔积液发生率较高。胸腔积液的发生与多种围手术期危险因素相关，应充分重视这些危险因素的评估和预防。

Objective To investigate the incidence and risk factors for pleural effusions after cardiac surgery with cardiopulmonary bypass. Methods 136 patients who underwent cardiac surgery with cardiopulmonary bypass in Peking Union Medical College Hospital from April 2012 to October 2013 were analyzed retrospectively. The patients were divided into two groups according to whether pleural effusions occurred after cardiac surgery. We observed the clinical data of the patients in both groups. The data were analyzed with SPSS 16.0 software package. Results Of the 136 patients, pleural effusions developed in 53 patients. The incidence rate was 39%. The statis- tical analysis revealed that low preoperative cardiac function, atrial fibrillation, peripheral vascular disease, preop- erative anticoagulants, Clopidogrel, ACEI, antiarrhythmics were the risk factors for pleural effusions in post car- diac surgical patients. Conclusion The incidence rate of pleural effusions after cardiac surgery with cardiopul- monary bypass is high. The development of pleural effusions is closely related with various perioperative risk fac- tors, suggesting more attention should be paid to the assessment and prevention of these risk factors.