成人体外循环下心脏手术后围术期并发症的相关因素分析

Related factors for complications during the perioperative period in adult patients after cardiac surgery with extracorporeal circulation

目的探讨成人患者体外循环下心脏手术围术期并发症发生的相关因素。方法收集120例成人患者行体外循环下心脏手术的临床资料,采用单因素分析、多因素Logistic回归分析与围术期并发症发生的相关影响因素。结果 (1)患者手术死亡率为1.7%(2/120),并发症发生率为31.7%(38/120);(2)发生与未发生并发症两组患者在术前吸烟、伴发高血糖、体外循环时间≥2 h、主动脉阻断时间≥90 min、输血量≥2 000 ml共5项指标比较差异均有统计学意义(P<0.05);(3)多因素Logistic回归分析显示,术前吸烟、伴发高血糖、体外循环时间≥2 h、输血量≥2 000 ml是围术期发生并发症的危险因素(OR>1,P<0.05)。结论患者术前吸烟、伴发高血糖、术中体外循环时间≥2 h以及输血量≥2 000 ml是成人行体外循环下心脏手术围术期并发症发生的危险因素。

Objective To explore the related factors for complications during the perioperative period in adult patients after cardiac surgery with extracorporeal circulation. Methods The clinical data of 120 adult patients undergoing cardiac surgery with extracorporeal circulation were collected. The related factors of complications during the perioperative period were analyzed by univariate analysis and multivariate Logistic regression analysis. Results （1） The operative mortality rate was 1.7% （2/120）, and the postoperative complication rate was 31.7% （38/120）; （2） There were significant differences between the group with complications and the group without complications in smoking, hyperglycemia, time of eardiopulmonary bypass≥2 h, time of aortic cross clamping≥90 min, and blood transfusion volume≥2 000 ml （P〈0.05）; （3） Multivariate Logistic regression analysis revealed that the risk factors for complications in adult patients after cardiac surgery with extracorporeal circulation were smoking, hyperglycemia, time of eardiopulmonary bypass..≥ 2 h, and blood transfusion volume≥2 000 ml during the perioperative period （OR〉1, P〈0.05）. Conclusion The smoking and hyperglycemia before operation, time of cardiopulmonary bypass≥2 h and blood transfusion volume ≥ 2 000 ml during operation are significant risk factors for complications in adult patients after cardiac surgery with extracorporeal circulation during the perioperative period.