心脏瓣膜置换术后心律失常的危险因素分析

目的 探讨心脏瓣膜置换术后发生心律失常的危险因素.方法 回顾性分析2017年8月于我院至2019年8月于我院择期在体外循环下行心脏瓣膜置换手术213例患者的临床资料,其中男97例、女116例,平均年龄(53.4±10.5)岁,心功能分级(NYHA)Ⅱ～Ⅳ级.根据术后有无发生心律失常将患者分为术后非心律失常组和术后心律失...

Analysis of risk factors for arrhythmia in patients after heart valve replacement

Objective To explore and analyze the risk factors for arrhythmia in patients after heart valve replacement.Methods A retrospective analysis of 213 patients undergoing cardiac valve replacement surgery under cardiopulmonary bypass in our hospital from August 2017 to August 2019 was performed,including 97 males and 116 females,with an average age of 53.4±10.5 year and cardiac function classification(NYHA)grade ofⅡ-Ⅳ.According to the occurrence of postoperative arrhythmia,the patients were divided into a non-postoperative arrhythmia group and a postoperative arrhythmia group.The clinical data of the two groups were compared,and the influencing factors for arrhythmia after heart valve replacement were analyzed by logistic regression analysis.Results There were 96(45%)patients with new arrhythmia after heart valve replacement surgery,and the most common type of arrhythmia was atrial fibrillation(45 patients,18.44%).Preoperative arrhythmia rate,atrial fibrillation operation rate,postoperative minimum blood potassium value,blood magnesium value in the postoperative arrhythmia group were significantly lower than those in the non-postoperative arrhythmia group(P<0.05);hypoxemia incidence,hyperglycemia incidence,acidosis incidence,fever incidence probability were significantly higher than those in the non-postoperative arrhythmia group(P<0.05).The independent risk factors for postoperative arrhythmia were the lowest postoperative serum potassium value(OR=0.305,95%CI 0.114-0.817),serum magnesium value(OR=0.021,95%CI 0.002-0.218),and hypoxemia(OR=2.490,95%CI 1.045-5.930).Conclusion Taking precautions before surgery,improving hypoxemia after surgery,maintaining electrolyte balance and acid-base balance,monitoring blood sugar,detecting arrhythmia as soon as possible and dealing with it in time can shorten the ICU stay time,reduce the occurrence of complications,and improve the prognosis of patients.