心脏瓣膜置换术患者术后发生低心排血量综合征的危险因素

Risk Factors for the Occurrence of Llow Cardiac Output Syndrome in Patients Undergoing Heart Valve Replacement Surgery

目的探讨心脏瓣膜置换术(CVR)患者术后发生低心排血量综合征(LCOS)的危险因素。方法采用便利抽样方式选取2020年5月至2021年5月于医院行CVR治疗的96例患者为研究对象,根据是否发生LCOS分为LCOS组和非LCOS组,收集两组一般资料,分析CVR患者术后发生LCOS的危险因素。结果96例患者中24例发生LCOS,72例未发生LCOS。LCOS组体质量指数≤18.5 kg/m^(2)、术前纽约心脏病协会(NYHA)心功能分级Ⅲ~Ⅳ级、术前合并肾功能不全、合并电解质紊乱、体外循环时间>140 min、围手术期失血量>总血量20%的占比高于非LCOS组,差异有统计学意义(P<0.05);Logistic回归分析结果显示,体质量指数≤18.5 kg/m^(2)、术前NYHA心功能分级Ⅲ~Ⅳ级、术前合并肾功能不全、合并电解质紊乱、体外循环时间>140 min、围手术期失血量>总血量20%是CVR患者术后发生LCOS的高危因素(OR>1,P<0.05)。结论CVR患者术后发生LCOS与体质量指数、术前NYHA心功能分级、术前合并肾功能不全、合并电解质紊乱、体外循环时间、围手术期失血量>总血量20%有关。

Objective The Risk factors for postoperative low cardiac output syndrome(LCOS)in patients undergoing cardiac valve replacement(CVR)were explored.Methods With selection of 96 patients who underwent CVR treatment in hospitals from May 2020 to May 2021 as the study subjects using convenience sampling method,the patients were divided into LCOS group and non LCOS group,depending on whether LCOS occurred.With the collection of general data from both groups,the risk factors for postoperative LCOS in CVR patients were analyzed.Results LCOS occurred in 24 of 96 patients,with an incidence of 25.00%.The proportion of LCOS group with a body mass index≤18.5 kg/m^(2),preoperative New York Heart Association(NYHA)heart function gradingⅢ-Ⅳ,preoperative renal dysfunction,electrolyte disorders,extracorporeal circulation time>140 minutes,and perioperative blood loss>20%of total blood volume was higher than that of non LCOS group,and the differences were statistically significant(P<0.05).The results of Logistic regression analysis showed that body mass index≤18.5 kg/m^(2),preoperative NYHA heart function gradingⅢ-Ⅳ,preoperative renal dysfunction,electrolyte disorders,extracorporeal circulation time>140 minutes,and perioperative blood loss>20%of total blood volume were high-risk factors for postoperative LCOS in CVR patients(OR>1,P<0.05).Conclusion The occurrence of postoperative LCOS in CVR patients is related to body mass index,preoperative NYHA cardiac function grading,preoperative concomitant renal dysfunction,electrolyte disorders,extracorporeal circulation time,and perioperative blood loss greater than 20%of total blood volume.