体外循环冠状动脉旁路移植术后低氧血症的危险因素分析
许卫江1 陈祖君1 肖红艳1 梁艳娥1 刘彬1
武汉亚洲心脏病医院
目的 通过分析体外循环冠状动脉旁路移植术后低氧血症的危险因素，认识体外循环冠状动脉旁路移植术后低氧血症的发生规律及特点。方法 对86例体外循环冠状动脉旁路移植术后发生低氧血症的相关因素进行单因素和多因素分析。结果 单因素分析显示: 高龄（≥65岁）、长期吸烟、糖尿病、慢性阻塞性肺气肿病史、术前左室射血分数＜45%、过度肥胖、血制品输入≥1000ml等因素可能会导致术后低氧血症的发生；多因素分析显示: 术前肺功能异常、体外循环时间过长（≥2h）、低蛋白血症以及肺部感染是术后低氧血症发生的独立危险因素。结论 体外循环冠状动脉旁路移植术后低氧血症是围术期多种因素共同作用的结果，提高对围术期低氧血症危险因素的认识，正确指导临床预防与治疗，可以避免和减轻术后低氧血症的发生。
Abstract：Objective To analysis the risk factors,which lead to hypoxemia after coronary artery bypass grafting(CABG) with extracorporeal circulation. Methods The risk factors were studied by means of both single factor analysis and multivaritat Logistec regerssion analysis 86 patients with hypoxemia after CABG with cardiopulmonary bypass. Results One way analysis indicated: which lead to hypoxemia after CABG with extracorporeal circulation by unifactor analysis were related to senility(≥65y),history of smoking,diabets mellitus, chronic obstructive pulmonary disease
(COPD), left ventricular ejection fraction(LVEF＜45%), obesity before operation, transfution（≥1000ml）; multivariate analysis indicated : pulmonary dysfuction before operation, longer extracorporeal circulation time（≥2h）,hypoalbuminemia and pulmonary infection. Conclusion Multiple risk factors lead to hypoxemia after extracorporeal circulation; recognize these risk factors and instruct clinic treatment can avoid the hypoxemia postoperative .
Key words：extracorporeal circulation; CABG; cardiac surgery; hypoxemia; risk factors
