摘要
目的:探讨老年患者行腹腔镜胆囊切除术后心房颤动的危险因素.方法:回顾分析 2022 年 1 月至 2024 年 7 月接受腹腔镜胆囊切除术的183 例老年患者的临床资料.根据术后有无并发心房颤动分为心律失常组与对照组(无心律失常).比较两组患者临床资料,包括年龄、性别、吸烟史、高血压史、糖尿病史、冠心病史、心脏彩超中左心房内径、手术时间、出血量及手术前后C反应蛋白水平、白细胞水平等,采用单因素与多因素Logistic回归分析方法,分析老年患者腹腔镜胆囊切除术后心房颤动的相关因素.结果:9 例患者于术后3d内出现心房颤动.单因素分析发现,年龄、手术时间、出血量、术后C反应蛋白、术后白细胞、冠心病为危险因素;多因素分析显示,年龄、手术时间、出血量、术后白细胞、冠心病为独立危险因素.结论:对于行腹腔镜胆囊切除术的老年患者可通过年龄、手术时间、出血量、术后白细胞、冠心病等指标推断术后发生心房颤动的可能性,围手术期对危险因素进行积极干预,以减少术后心房颤动的发生.
Abstract
Objective:To investigate the risk factors of atrial fibrillation after laparoscopic cholecystectomy in elderly patients.Methods:The clinical data of 183 elderly patients who underwent laparoscopic cholecystectomy from Jan.2022 to Jul.2024 were retro-spectively analyzed.The patients were divided into arrhythmia group and control group(non-arrhythmia group)according to whether there was postoperative atrial fibrillation.The clinical data of the two groups were compared,including age,gender,smoking history,hy-pertension,diabetes,coronary heart disease,left atrial diameter in cardiac color ultrasound,operation time,blood loss,preoperative and postoperative C-reactive protein and leukocyte levels,etc.Univariate and multivariate logistic regression analysis were used to explore the related factors of atrial fibrillation after laparoscopic cholecystectomy.Results:Nine patients developed atrial fibrillation within 3 d after operation.Univariate analysis showed that age,operation time,blood loss,postoperative C-reactive protein,postoperative leucocyte,and coronary heart disease were risk factors,while multivariate analysis showed that age,operation time,blood loss,postoperative leuco-cyte,and coronary heart disease were independent risk factors.Conclusions:Age,operation time,blood loss,postoperative leucocyte,and coronary heart disease can be used to predict the possibility of postoperative atrial fibrillation in elderly patients undergoing laparoscopic cholecystectomy.Active intervention of risk factors during the perioperative period can reduce the occurrence of postoperative atrial fibrillation.
基金项目
山东省医务职工科技创新计划联合立项项目(SDYWZGKCJHLH2023075)
国家科技期刊平台
NSTL
万方数据