ICU心脏外科术后成人患者压力性损伤影响因素分析

Influence Factors of Stress Injury of Adult Patients after Cardiac Surgery in ICU

目的探讨ICU心脏外科术后成人患者压力性损伤影响因素。方法回顾性分析2017年1—12月新疆医科大学第一附属医院ICU收治的心脏外科术后成人患者322例,描述患者临床资料及压力性损伤情况,同时采用单因素分析和多因素Logistic回归分析方法确定ICU心脏外科术后患者压力性损伤的影响因素。结果多因素Logistic回归分析显示,年龄、术中输血量是ICU心脏外科术后患者发生压力性损伤的独立危险因素(P<0.05)。性别、体外循环时间、术中最低体温是ICU心脏外科术后患者发生压力性损伤的保护因素(P<0.05)。结论 ICU心脏外科术后成人患者压力性损伤发生率较高,年龄、性别、术中输血量、体外循环时间、术中最低体温是其影响因素。临床护理时应对患者进行全面评估,对患者术中输血量、体外循环时间、术中体温做到严格把控,同时给予患者围术期预见性干预措施,以降低ICU心脏外科术后患者压力性损伤发生率,提升护理服务质量。

Objective To explore the influence factors of stress injury of adult patients after cardiac surgery in intensive care unit(ICU).Methods A retrospective analysis was performed on 322 cases of postoperative cardiac surgery adult patients admitted to the ICU of the First Affiliated Hospital of Xinjiang Medical University from January to December 2017.The clinical data and stress injury of the patients were described.Univariate analysis and multivariate logistic regression analysis were used to determine the influence factors of stress injury in postoperative cardiac surgery patients.Results The multiple logistic regression analysis showed that age and intraoperative blood transfusion volume were independent risk factors for stress injury after cardiac surgery in ICU patients(P﹤0.05).Gender,length of extracorporeal circulation,and intraoperative minimum body temperature were protective factors for stress injury after cardiac surgery in ICU patients(P﹤0.05).Conclusion The incidence of stress injury of adult patients after cardiac surgery in ICU is high,age,gender,intraoperative blood transfusion volume,length of extracorporeal circulation,and intraoperative minimum body temperature were influence factors.A comprehensive assessment of the patients is recommended.More attention should be paid to intraoperative blood transfusion volume,extracorporeal circulation time and intraoperative minimum body temperature.Meanwhile,predictive measures should be taken for patients thus to reduce the incidence of stress injury of ICU patients after cardiac surgery and to improve the quality of nursing service.