在非透析依赖性功能不良患者中进行冠状动脉旁路移植
1Division of Cardiovascular Surgery, Sunnybrook Health Science Centre and The Toronto Hospital, Ontario, Canada.
Circulation
|December 31, 1997
概括
接受冠状动脉旁路移植 (CABG) 手术的轻度功能不全患者面临更高的风险. 这包括增加对输血的需求,低输出综合征和更长的住院时间,即使没有透析依赖.
科学领域:
- 心脏病学 心脏病学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 外科手术的结果
背景情况:
- 手术前的功能衰竭显著增加了与冠状动脉旁路移植 (CABG) 手术相关的发病和死亡风险.
- CABG对轻度,非透析依赖性功能不全的患者的影响在很大程度上仍未被描述.
研究的目的:
- 为了研究与没有这种情况的对照组相比,在患有轻度手术前功能衰竭的患者中单独的CABG的结果.
主要方法:
- 从2978名隔离的CABG患者 (1990-1996) 中确定了一组38名患有手术前功能不全的患者 (血清肌素>150微摩尔/升).
- 这些患者与152名对照患者相匹配,基于六个预后变量.
- 需要进行手术前透析的患者被排除在分析之外.
主要成果:
- 功能不良组患上晚年,糖尿病,高血压,外周血管疾病和左心室功能障碍的患病率更高.
- 患有功能不全的患者更有可能需要术前输血 (P<.001) 和术后透析 (P<.01).
- 较长的通风时间,重症监护室 (ICU) 停留时间和术后住院时间在功能不全组中被观察到. 轻度功能衰竭独立预测术后低输出综合征 (OR=3.6).
结论:
- 轻度功能衰竭,独立于透析状态,与CABG期间的风险增加有关.
- 这些风险包括更有可能接受输血,发展低输出综合征,以及手术后延长ICU和医院停留时间.
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