摘要
目的探讨重症心脏瓣膜病患者行瓣膜置换术后发生低心排综合征(LCOS)的相关危险因素。方法对87例重症心脏瓣膜病患者行心脏瓣膜置换术,根据术后是否发生LCOS将其分为观察组(发生LCOS)和对照组(未发生LCOS)。采用单因素分析和二分类Logistic回归分析对患者的临床资料进行统计分析。结果单因素分析结果显示:术前心功能Ⅳ级、术前合并肾功能不全、主动脉阻断时间>70min、失血比>20%(失血量/总血容量>20%)、高血压、体外循环时间>100 min、术前心律失常等组间差异有统计学意义(P=0.030、0.016、0.048、0.019、0.013、0.017、0.029);进一步二分类Logistic回归分析表明:患者术前心功能Ⅳ级、体外循环时间>100 min、失血比>20%、术前合并肾功能不全是术后发生LCOS的独立危险因素(P=0.035、0.030、0.019、0.014)。结论患者术前心功能Ⅳ级、体外循环时间>100 min、失血比>20%、术前合并肾功能不全为重症心脏瓣膜病患者术后发生LCOS的重要危险因素。
Objective To investigate the related risk factors of low cardiac output syndrome （LCOS） after heart valve replacement in patients with severe valvular heart disease. Methods 87 patients with severe valvular heart disease who underwent heart valve replacement were involved in this study, according to the occurrence of LCOS after operation, patients with postoperative LCOS were in the observation group, patients without postoperative LCOS were in the control group. The risk factors for LCOS were determined by means of utilized univariate analysis and two classification Logistic regression analysis. Results Univariate analysis showed that preperative cardiac function class Ⅳ, preperative renal dysfunction, aortic clamping time〉70 min, blood loss ratio〉20%（blood loss/total blood volume〉20%）, hypertension, cardiopulmonary bypass time〉100 min and Preoperative cardiac arrhythmia all had statistically significant differences between two groups （ P =0.030, 0.016, 0.048, 0.019, 0.013, 0.017, 0.029 ）. Two classification Logistic regression analysis showed that preperative cardiac function class Ⅳ, preperative renal dysfunction, the ratio of blood loss〉20% （blood loss/total blood volume〉20%） and cardiopulmonary bypass time〉100 min were all the independent risk factors for LCOS after heart valve replacement surgery （ P =0.035, 0.030, 0.019, 0.014 ）. Conclusion The independent predictors of LCOS after heart valve replacement are preperative cardiac function class Ⅳ, preperative renal dysfunction, the ratio of blood loss〉20% （blood loss/total blood volume〉20%） and cardiopulmonary bypass time〉100 min in patients with severe valvular heart disease.
作者
钱鹏
石开虎
陶辉
代晨
秦润禾
汪裕琪
徐盛松
Qian Peng;Shi Kaihu;Tao Hui(Dept of Thoracic and Cardiovascular Surgery,The Second Affiliated Hospital of Anhui Medical University,Hefei 230061;Cardiovascular Research Center of Anhui Medical University,Hefei 230601)
出处
《安徽医科大学学报》
CAS
北大核心
2018年第9期1436-1439,共4页
Acta Universitatis Medicinalis Anhui
基金
国家自然科学基金(编号:81570295)
安徽省科技攻关计划项目(编号:1501041148)
安徽高校自然科学研究项目(编号:KJ2017A168)
关键词
重症心脏瓣膜病
瓣膜置换术
低心排综合征
危险因素
severe valvular heart disease
valve replacement
low cardiac output syndrome
risk factors
