摘要
心脏手术术后消化道出血发生率虽低,但死亡率较高且早期难于发现及诊断。其发病高危因素包括术前、术中及术后三部分,术前伴有消化道溃疡、高血压、冠心病、慢性肾功能衰竭等;术中体外循环导致的胃肠道血流灌注降低、炎性物质大量释放、凝血机制的改变、各类成分栓子的形成;术后低血压、低心排血量、机械通气时间延长等。本文将着重归纳心脏手术后消化道出血的高危因素及发病机制,回顾性总结心脏手术术后消化道出血的预防、治疗进展及目前存在的问题。
Although the incidence of gastrointestinal hemorrhage after cardiac surgery is low,the mortality rate is high.Early detection and diagnosis of gastrointestinal hemorrhage are difficult.The high risk phases including preoperation,intraoperation and postoperation.Preoperative high risk comorbidities include gastrointestinal ulcer, hypertension,coronary heart disease and chronic renal failure.Intraoperative high risk factors include decreased gastrointestinal blood perfusion due to cardiopulmonary bypass,inflammatory factors releasing,coagulation disorders, and thrombosis.Postoperative high risk factors include hypotension,low cardiac output,prolonged mechanical ventilation,etc.This article retrospectively summarized high-risk factors and pathogenesis of gastrointestinal hemorrhage after cardiac surgery,in order to improve prevention and treatment of gastrointestinal hemorrhage.
作者
曾玲
廖尧
钱永军
ZENG Ling;LIAO Yao;QIAN Yongjun(Department of Intensive Care Unit,West China Hospital,Sichuan University,Chengdu,610041,P.R.China;Department of Cardiovascular Surgery,Jingzhou Central Hospital,Jingzhou,434000,Hubei,P.R.China;Department of Cardiovascular Surgery,West China Hospital,Sichuan University,Chengdu,610041,P.R.China)
出处
《中国胸心血管外科临床杂志》
CAS
CSCD
2019年第1期97-100,共4页
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
基金
国家"十三五"重点研发专项资助(2016YFC1302003)
四川省科技计划重点研发项目(2017SZ0056)
四川省卫生和计划生育委员会科研课题(17PJ177)
关键词
心脏手术
消化道出血
研究进展
Cardiac surgery
gastrointestinal hemorrhage
research progress