右美托咪定对体外循环下心脏手术后患者预后的影响

Effect of dexmedetomidine on prognosis after cardiac surgery with cardiopulmonary bypass

评价右美托咪定对体外循环（CPB）下心脏手术后患者预后的影响。回顾性分析2013年9月-2015年5月CPB下心脏手术患者753例，性别不限，年龄18～84岁，按照术中是否使用右美托咪定将其分为2组：对照组（C组，n=548）和右美托咪定组（D组，n=205）。采用卡钳法进行倾向值匹配后，197对患者的资料匹配成功。收集术后心律失常的发生情况、院内死亡情况、术后肺部感染、急性。肾损伤的发生情况、ICU停留时间、住院时间、30d内再次人院情况。与C组比较，D组术后快速型心律失常发生率和院内死亡率降低（P〈0．05）；缓慢型心律失常发生率、术后肺部感染发生率、术后急性肾损伤发生率、ICU停留时间、住院时间、30d内再次入院率差异无统计学意义（P〉0．05）。右美托咪定可有效改善CPB下心脏手术患者的预后。

To evaluate the effect of dexmedetomidine on prognosis after cardiac surgery with cardiopulmonary bypass （CPB） in the patients. For this retrospective study, 753 patients of both sexes, aged 18-84 yr, who underwent cardiac surgery with CPB from September 2013 to May 2015, were divided into 2 groups depending on whether or not dexmedetomidine was used during surgical procedures： control group （group C, n= 548） and dexmedetomidine group （group D, n = 205）. Propensity score matching analysis with preset caliper width was used. A total of 197 matched pairs were selected from the patients. The development of postoperative arrhythmia, in-hospital mortality, pulmonary infection after operation, and acute renal injury, length of intensive care unit stay, length of hospital stay and 30-day readmission to the hospital were collected. Compared with group C, the incidence of postoperative tachyarrhythmia and in- hospital mortality rate were significantly decreased （P〈0.05） , and no significant changes were found in the incidence of postoperative bradyarrhythmia, pulmonary infection after operation and postoperative acute renal injury, length of intensive care unit stay, length of hospital stay and rate of 30-day readmission to the hospital in group D （P〉 0.05）. Dexmedetomidine can effectively improve prognosis after cardiac surgery with CPB in the patients.