高血压病史对体外循环冠脉搭桥术后早期预后的影响

Impact of A History of Hypertension on the Prognosis during the Early Period after Coronary Artery Bypass Grafting(CABG)

目的 :了解高血压病史对体外循环下冠脉搭桥术后早期预后的影响。方法 :对高血压和非高血压行体外循环下冠脉搭桥术年龄大于60岁的冠心病患者65例术前和术后早期的临床资料进行分析。结果 :与非高血压患者相比 ,患高血压的病人冠脉搭桥术后心律失常的发生率增高 ,术后30min动脉氧分压与吸入氧浓度 (PaO2/FiO2)比值明显低下 ,机械通气时间明显延长 ,术后24h内胸腔引流量明显增加 ,术后大剂量多巴胺 (>10μg·kg-1·min -1)应用率及重症监护时间无显著性差异。结论 :高血压病史使患者冠脉搭桥术后早期肺功能下降、心律失常发生率增高、出血倾向增加 。

Objective:To study the relationship between hypertension and the outcome of early period after CABG.Methods:We investigated 65 patients older than 60 years who underwent CABG surgery with cardiopulmonary bypass from Jaunary 2000 to July 2001.Patients with a history of hypertension were compared with those without a history of hypertension.Results:In the early period after CABG,patients with a history of hypertension had a higher risk of arrhythmia,lower PaO2/FiO2 ratio,and longer intubation period.The hypertension patients also had more blood loss in the first 24 hours after operation.Although hypertension patients had a higher rate of receiving dopamine more than 10 μg·kg-1· min-1,and a longer ICU stay,there was no statistical difference between them and non_hypertension patients.Conclusion:In the early period after CABG, hypertension was associated with decreased lung function,increased rate of arrhythmia,and more blood loss.Maintaining a normal blood pressure during and after operation maybe useful to update the prognosis after CABG.