冠状动脉旁路移植术术后低氧血症影响因素分析

目的探讨冠心病患者行冠状动脉旁路移植术（CABG）术后低氧血症危险因素。方法回顾分析2007年5月至2008年6月589例冠心病患者行CABG的临床资料。随访住院期间发生的低氧血症，比较发生低氧血症组患者和没有发生低氧血症组患者的性别、年龄、体表面积，术前心功能、左室射血分数（LVEF）、是否有长期吸烟史、是否合并慢性呼吸疾病和糖尿病等。对两组手术情况进行比较，如主动脉阻断时间、搭桥数量、是否体外循环手术、气管插管时间、ICU停留时间、术后出血量及二次开胸等并发症。结果589例患者平均年龄（61．2±8．5）岁。体外循环下行CABG482例，非体外循环下CABG（OPCABG）107例，平均移植血管（3．9±1．2）支。术后低氧血症的发生与年龄，术前心功能、LVEF，术后气管插管时间、ICU停留时间、出血等因素有关。结论CABG术后低氧血症有相对较高的病死率和并发症发生率，应关注术前呼吸功能，加强围手术期的管理。

The risk factors of hypoxia after coronary artery bypass grafting operation in patients with coronary heart disease

Objective To investigate the risk factors of hypoxia after coronary artery bypass grafting （CABG） operation in 589 coronary heart disease patients. Methods From May 2007 to June 2008, 589 patients received CABG. The difference risk factors between hypoxia group and no-hypoxia group after CABG operation were compared. Results The post operation hypoxia were found correlated with older, lower heart function, and delayed post-operation intube time, ICU stay time, and bleeding. Conclusion Due to correspondingly high mortality and morbidity in hypoxia patients who underwent CABG, respiratory function should be paid close attention, and also peri-operation management should be strengthened.