传统和跳动心脏冠状动脉手术后心房的预测因素:一项前性随机研究
Circulation
|September 27, 2000
概括
随着心性停止的心肺绕道 (CPB) 显著增加了冠状动脉绕道移植 (CABG) 后术后心房动 (AF) 的风险. 在跳动的心脏上进行脱手术可以减少AF的发生.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 临床研究 临床研究
背景情况:
- 心房动 (AF) 是冠状动脉旁路移植 (CABG) 后的常见并发症,增加了患者的发病率.
- 在CABG之后的AF的确切原因尚未完全理解,目前的预防策略是不够的.
研究的目的:
- 调查心肺绕道 (CPB) 和心性停止在术后AF发展中的作用.
- 为了比较在接受内CABG和外CABG的患者中AF的发生率.
主要方法:
- 一项前性随机研究,涉及200名接受CABG的患者.
- 患者被分配到具有CPB和心脏性停止的常规式手术或在跳动的心脏上进行式手术.
- 术后AF使用自动心律失常检测和随后的临床观察进行了72小时的监测.
主要成果:
- 在100名抽患者中,有39名患有持续的术后肌痛动脉,而在100名抽患者中,只有8名患有持续的肌痛动脉 (P=0.001).
- 单变量分析确定了CPB与心肌停止,内支持,输管时间,胸部感染和住院作为AF预测因素.
- 多变量回归分析证实CPB与心性停止是术后AF (OR 7.4) 的唯一独立预测因子.
结论:
- 结合心肌的心肺绕道 (CPB) 是手术后心房的主要独立风险因素,在接受冠状动脉再血管化的患者中.
- 外CABG可能是减少术后AF发生率的一种策略.
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