体外循环下冠状动脉旁路移植术患者抑郁障碍调查及影响因素分析

Investigation and influencing factors of depressive disorder in patients undergoing on-pump coronary artery bypass grafting

目的 探讨体外循环下冠状动脉旁路移植术患者发生抑郁障碍的状况及影响因素。方法 统计体外循环下冠状动脉旁路移植术治疗的650例冠心病患者术后抑郁障碍发生状况,并进行单因素分析和多元Logistic回归分析探讨其影响因素。结果 650例患者术后发生抑郁障碍273例,发生率为42.00%。单因素分析发现,体外循环下冠状动脉旁路移植术后是否发生抑郁障碍在年龄、受教育时间、术前抑郁、≥2次心肌梗死、心功能、急诊手术、体外循环时间、主动脉阻断时间、术后神经功能缺损评分方面存在显著差异(P<0.01)。多元Logistic回归显示,年龄≥65岁、术前抑郁、体外循环时间≥150 min、术后神经功能缺损评分≥25分为体外循环下冠状动脉旁路移植术后发生抑郁障碍的危险因素。结论 体外循环下冠状动脉旁路移植术患者抑郁障碍发生率较高,其影响因素较多,对存在危险因素的患者应早期予以针对性干预,减少抑郁障碍的发生。

Objective To investigate the status and influencing factors of depressive disorder in patients undergoing on-pump coronary artery bypass grafting(ONCABG). Methods The incidence of postoperative depressive disorder in 650 patients undergoing ONCABG was analyzed. Univariate analysis and multiple logistic regression analysis were used to explore the influencing factors. Results Among the 650 patients, 273 had depressive disorder after operation, with an incidence of 42.00%. Univariate analysis showed that there were significant differences in age, schooling year, preoperative depression, twice or more myocardial infarctions, cardiac function, emergency surgery, cardiopulmonary bypass time, aortic cross-clamping time, and postoperative neurological deficit score for depressive disorder after ONCABG(P<0.01). Multiple logistic regression showed that age greater than or equal to 65 years old, preoperative depression, cardiopulmonary bypass time greater than or equal to 150 min, and postoperative neurological deficit score greater than or equal to 25 were risk factors for depressive disorder after ONCABG. Conclusions The incidence of depressive disorder in patients undergoing ONCABG is higher, and there are many influencing factors. Early targeted intervention should be given to patients with risk factors to reduce the occurrence of depressive disorders.