摘要
目的探讨危重烧伤并发术后心房颤动(POAF)患者的临床特征并分析其危险因素。方法采用回顾性病例系列研究方法。2017年1月—2021年12月,暨南大学医学院附属广州红十字会医院收治符合入选标准的227例危重烧伤成年患者,其中男173例、女54例,年龄19~83(43±14)岁。收集患者入院年份,并计算各年份中并发POAF患者所占百分比。根据患者是否并发POAF,将其分为POAF组(17例)和非POAF组(210例),收集POAF组患者每次并发POAF前的手术方式、手术时长、术中失血量及POAF的发生时间和次数,术后患者体温、血压、血红蛋白、血糖、血乳酸、脓毒症及电解质情况,POAF类型、持续时间及处理方式等资料;收集并分析2组患者年龄、性别、受伤原因、烧伤总面积、Ⅲ度烧伤面积,入院时急性生理学和慢性健康状况评价Ⅱ(APACHEⅡ)评分、脓毒症相关性器官功能衰竭评价(SOFA)评分,合并高血压、糖尿病、其他类型心律失常等基础性疾病及脓毒症等一般资料情况;收集并分析2组患者机械通气时间、手术次数、住烧伤重症监护病房(BICU)时间等影响预后的因素和病死率。对数据行独立样本t检验、Mann-Whitney U检验、χ^(2)检验或Kruskal-Wallis H检验。对2组比较中差异有统计学意义的一般资料的数据,行多因素logistic回归分析并筛选影响227例危重烧伤患者发生POAF的独立危险因素。结果2017—2021年危重烧伤患者并发POAF的百分比呈逐年上升趋势。POAF组患者并发POAF前的手术方式以四肢切削痂术为主、手术时长(3.5±1.2)h、术中失血量(365±148)mL。POAF组患者并发POAF的时间多集中于伤后1周内的术后6 h内。POAF组患者共并发POAF 25次,其中大部分患者仅发生1次;POAF发生时,患者多合并有低体温、贫血、高血糖、高血乳酸、脓毒症以及电解质紊乱,较少患者合并低血压;POAF的持续时间为(5±3)h,均为阵发性心房颤动;多�
Objective To investigate the clinical characteristics and risk factors of postoperative atrial fibrillation(POAF)in patients with critical burns.Methods A retrospective case series study was conducted.From January 2017 to December 2021,two hundred and twenty-seven critically burned aldult patients who met the inclusion criteria were admitted to Guangzhou Red Cross Hospital of Jinan University,including 173 males and 54 females,aged 19-83(43±14)years.The admission years of patients were collected,and the percentage of patients complicated with POAF in each year was calculated.According to whether the patients were complicated with POAF or not,they were divided into POAF group(n=17)and non-POAF group(n=210).Following data were collected in patients in POAF group,including operation methods,duration of operation,intraoperative blood loss before occurrence of POAF each time,occurrence time and times of POAF,postoperative body temperature,blood pressure,hemoglobin,blood glucose,blood lactate,sepsis,and electrolyte,and type,duration,and treatment of POAF.General data of patients in the two groups including age,gender,burn reason,total burn area,full-thickness burn area,acute physiology and chronic health evaluationⅡ(APACHEⅡ)and sepsis-related organ failure evaluation(SOFA)scores on admission,combined with underlying diseases(hypertension,diabetes,and other types of arrhythmias),and sepsis were collected and analyzed.The mortality and factors influencing the prognosis of patients in the two groups such as mechanical ventilation time,operations times,and burn intensive care unit(BICU)length of stay were also collected and analyzed.Data were statistically analyzed with independent sample t test,Mann-Whitney U test,chi-square test or Kruskal-Wallis H test.The multivariate logistic regression analysis was performed on the general data with statistically significant differences between the two groups,and the independent risk factors influencing the onset of POAF in 227 patients with critical burns were screened.Results
作者
陈宾
汤文彬
李孝建
欧莎莉
李欣滢
肖逵
王思思
Chen Bin;Tang Wenbin;Li Xiaojian;Ou Shali;Li Xinying;Xiao Kui;Wang Sisi(Department of Burns and Plastic Surgery of Guangzhou Red Cross Hospital,Jinan University,Guangzhou 510220,China)
出处
《中华烧伤与创面修复杂志》
CAS
CSCD
北大核心
2022年第5期408-414,共7页
Chinese Journal of Burns And Wounds
基金
广州市科学技术局2021年基础研究计划(33121052)
2021年广州市重点学科经费项目。
关键词
烧伤
心房颤动
手术后并发症
重症监护病房
危险因素
Burns
Atrial fibrillation
Postoperative complications
Intensive care units
Risk factors
