冠状动脉旁路移植术患者术后房颤的回顾性研究

Fei Li, M. Jia, X. Hou
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引用次数: 0

摘要

目的探讨冠状动脉旁路移植术(CABG)患者术后房颤(AF)的影响因素,探讨房颤术后并发症与康复的关系。方法2017年1月至2018年2月,首都医科大学附属北京安贞医院2 218例患者行单纯冠脉搭桥手术并返回ICU。排除术前房颤及植入起搏器患者后,共纳入1952例患者。根据术后是否发生房颤分为非房颤组[1 544例,男1 017例,女527例,平均年龄(63.20±9.47)岁]和新发房颤组[408例,男280例,女128例,平均年龄(69.32±8.93)岁]。记录性别、年龄、相关病史、心功能等因素。比较两组术后实验室检查指标、气管再插管率、气管切开率、死亡率、IABP和ECMO使用率、重症监护病房和住院时间。结果与非房颤组相比,新发房颤组气管插管率(P=0.007)、气管切开术率(P=0.039)、住院死亡率(P=0.039)较高,术后机械通气时间(P=0.010)、ICU时间(P=0.037)、住院时间(P=0.045)较长。多因素回归分析显示:高龄(P=0.028)、术后心源性休克(P=0.033)、术后AKI(P=0.041)、术后CRP升高(P=0.030)、术后TNI升高(P=0.028)、术后LAC升高(P=0.044)是CABG患者术后新发房颤的独立危险因素。结论冠状动脉搭桥术后新发房颤有较高的并发症和病死率。预防房颤的发生,及时改善心脏及重要脏器功能,降低死亡率是必要的。关键词:房颤冠状动脉搭桥术
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The retrospective research of postoperative atrial fibrillation in patients underwent coronary artery bypass grafting
Objective To research the influencing factors of postoperative atrial fibrillation(AF) in patients underwent coronary artery bypass grafting(CABG), and to explore the relationship between postoperative AF with complications and recovery. Methods From January 2017 to February 2018, 2 218 patients in Beijing Anzhen Hospital affiliated to Capital Medical University underwent simple CABG and returned to the ICU. After excluding preoperative AF and pacemaker implanted patients, a total of 1 952 patients were included in the research. According to whether there was postoperative AF, patients were divided into non-AF group [1 544 cases, male 1 017, female 527, averaged age(63.20±9.47)years old]and new-onset AF group [408 cases, male 280, female 128, averaged age(69.32±8.93) years old]. The gender, age, related medical history, cardiac function and other factors were recorded. And the postoperative laboratory test indicators, tracheal reintubation rate, tracheotomy rate, mortality, IABP and ECMO use rate, intensive care unit and hospital time were compared. Results Compared with the non-AF group, the rates of tracheal reintubation(P=0.007), tracheotomy(P=0.039), and hospital mortality(P=0.039) were higher on the new-onset AF group, and the postoperative mechanical ventilation time(P=0.010), the ICU time(P=0.037) and the hospital time(P=0.045) were longer. Multivariate regression analysis showed: advanced age(P=0.028), postoperative cardiogenic shock(P=0.033), postoperative AKI(P=0.041), postoperative CRP elevation(P=0.030), postoperative TNI elevation(P=0.028) and postoperative LAC elevation(P=0.044) were independent risk factors for postoperative new-onset AF in CABG patients. Conclusion Patients with new-onset AF after CABG have higher complication and mortality rate. It is necessary to prevent the occurrence of AF and improve the heart and vital organ function in time to reduce the mortality. Key words: Atrial fibrillation Coronary artery bypass grafting
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