代谢综合征对冠状动脉旁路移植术后患者出血及院内预后的影响

The Impact of Metabolic Syndrome on Post-operative Bleeding and In-hospital Prognosis in Patients With Coronary Artery Bypass Grafting

目的:探讨代谢综合征(MetS)对冠状动脉旁路移植术(CABG)后患者出血及院内预后的影响。方法:选取2012-06至2012-09在阜外医院单纯施行CABG的手术患者542例,根据有无合并MetS分为两组:MetS组(223例)、无MetS组(319例),比较两组患者术后24 h出血量和总出血量的差异及院内预后的情况,分析MetS对CABG后出血及预后的影响。结果:与无MetS组比较,MetS组女性患者的比例较高(17.9%vs 29.1%,P=0.002),术中、术后血浆输注率较低(20.7%vs 12.6%,P=0.015),术中、术后血浆为零输注量的患者比例较高(79.3%vs 87.5%,P=0.015)、术后24 h出血量中位数较低[710.00(530.00,950.00)ml vs 580.00(430.00,790.00)ml,P<0.01]及术后总出血量为0~500 ml的患者比例[4.4%vs10.8%,P=0.006]、术后总出血量在501 ml^1 000 ml区间内的患者比例均较高(41.1%vs 53.4%,P=0.005),术后24 h出血量>1 000 ml者(P=0.004)和术后总出血量在1001~2 000 ml及>2 001 ml范围内所占比例均较低(P=0.001,P=0.044)。结论:MetS患者CABG围手术期的血浆输注量、术后出血量减少及术后大出血的风险降低。Mets对CABG术后患者院内预后没有影响。

Objective： To explore the impact of metabolic syndrome（MS） on post-operative bleeding and in-hospital prognosis in patients with coronary artery bypass grafting（CABG）.Methods： A total of 542 patients received CABG in Fuwai hospital from 2012-06 to 2012-09 were enrolled. Based on existing MS, the patients were divided into 2 groups： MS group, n=223 and Non-MS group, n=319. The amounts of 24 h post-operative bleeding and total bleeding were compared between 2 groups; the impact of MS for in-hospital prognosis was studied.Results： Compared with Non-MS group, MS group had the higher ratio of female patients（17.9% vs 29.1%）, P=0.002; the lower ratio of patients with plasma transfusion during operation and post-operation（20.7% vs 12.6%）, P=0.015 and the higher ratio of patients with zero plasma transfusion during operation and post-operation（79.3% vs 87.5%）, P=0.015. The median of 24 h postoperative bleeding amount in MS group was lower [710.00（530.00, 950.00）ml vs 580.00（430.00, 790.00）ml, P〈0.001]. The ratio of patients with total post-operative bleeding amount from（0-500）ml and（501-1000）ml was higher in MS group（4.4% vs 10.8%, P=0.006;41.1% vs 53.4%, P=0.005,respectively）. MS group had the lower ratios of patients with 24 h post-operative bleeding amount〉1000 ml, P=0.004, with total post-operative bleeding amount from（1001-2 000） ml, P=0.001 and with total post-operative bleeding amount〉2 001 ml, P=0.044.Conclusion： MS patients had the lower amounts of peri-operative plasma transfusion and post-operative bleeding in CABG; while it had no impact on in-hospital prognosis.