不同BMI对中国冠状动脉搭桥术患者失血和输血的影响。

Mingya Wang, Ming Chen, Hushan Ao, Sipeng Chen, Zhifa Wang
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引用次数: 27

摘要

目的:失血是冠状动脉旁路移植术(CABG)后预后的预测指标。本研究探讨体重指数(BMI)对中国冠状动脉搭桥患者出血量、输血率及凝血参数变化的影响。方法选取2013年1月1日至2013年12月31日在阜外医院连续行孤立原发性冠脉搭桥的1007例中国患者作为研究对象。按BMI分为BMI <24 kg/m2组(低、正常体重组)、24≤BMI <28 kg/m2组(超重组)、BMI≥28 kg/m2组(肥胖组)。根据BMI分类,分析失血量和记录的输血量。结果低体重组和正常体重组的失血量和输血率明显高于肥胖组(p <0.01)。24 h胸管引流、重症监护病房(ICU)住院时间、术后机械通气时间均高于对照组(p <0.01)。心房颤动与输血密切相关(p <0.001)。结论肥胖是中国人预防失血和输血的一个预测指标。在孤立的原发性冠脉搭桥期间,BMI较低和正常的患者每公斤体重失血量更多,总输血量也更高。心房颤动与大量输血有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Effects of Different BMI on Blood Loss and Transfusions in Chinese Patients Undergoing Coronary Artery Bypass Grafting.
OBJECTIVE Blood loss is a predictor of outcomes after coronary artery bypass grafting (CABG). This study investigated the effects of body mass index (BMI) on blood loss, blood transfusion rate, and the variations in coagulation parameters of Chinese patients undergoing CABG. METHODS A total of 1007 Chinese patients who consecutively underwent isolated, primary CABG at Fuwai Hospital from January 1, 2013 to December 31, 2013 were included in this study. They were categorized by BMI into <24 kg/m2 (low and normal weight group), 24≤ BMI <28 kg/m2 (overweight group), and BMI ≥28 kg/m2 (obese group). Following this BMI classification, the quantities of blood lost and recorded transfusions were analyzed. RESULTS Blood loss and transfusion rates were significantly higher in the low and normal weight group compared with the obese group (p <0.01). Chest tube drainage over 24 h, duration of intensive care unit (ICU) stay, and postoperative mechanical ventilation were higher as well (p <0.01). Atrial fibrillation was closely related to blood transfusion (p <0.001). CONCLUSIONS Obesity is a predictor for protection against blood loss and transfusion in Chinese people. Patients with low and normal BMI lost more blood per kg of their weight and had higher total transfused volume during isolated primary CABG. Atrial fibrillation was associated with high blood transfusion.
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