摘要
目的 探讨并分析老年患者体外循环下心脏手术后发生急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)的危险因素.方法 选择2020年1月至2023年1月于青岛市市立医院就诊的250例接受体外循环治疗的老年心脏手术患者作为研究对象,将心脏手术后发生ARDS的20例患者作为ARDS组,未发生ARDS的230例作为非ARDS组.比较两组患者的年龄、性别、吸烟、饮酒、糖尿病、高血压、NYHA心功能分级、术中出血量、术中输血量、体外循环时间、主动脉阻断时间,采用Logistic回归分析影响老年体外循环下心脏术后发生ARDS的危险因素.结果 两组患者的年龄、性别、吸烟、饮酒、糖尿病、高血压比较,差异无统计学意义(P＞0.05);老年体外循环下心脏手术后发生ARDS与NYHA心功能分级、术中出血量、术中输血量、体外循环时间、主动脉阻断时间相关(P＜0.05);经Logistic回归分析结果显示,NYHA心功能分级、术中出血量、术中输血量、体外循环时间、主动脉阻断时间均是影响老年体外循环下心脏手术后发生ARDS的危险因素(P＜0.05).结论 NYHA心功能分级、术中出血量、术中输血量、体外循环时间、主动脉阻断时间均是影响老年体外循环下心脏手术后发生ARDS的危险因素.
Abstract
Objective To discuss the risk factors for acute respiratory distress syndrome(ARDS)in elderly patients undergone heart surgeryunder cardiopulmonary bypass(CPB).Methods The elderly patients undergone heart surgeryunder CPB(n=250)were chosen from Municipal Hospital of Qingdao City from Jan.2020 to Jan.2023.The patients with postoperative ARDS were chosen into ARDS group(n=20)and those without ARDS were chosen into non-ARDS group(n=230).The indexes of age,gender,smoking,drinking,diabetes,hypertension,NYHA classification of heart function,intraoperative blood loss,intraoperative blood transfusion,CPB time and aortic occlusion time were compared between 2 groups.The risk factors for ARDS were analyzed by using Logistic regression analysis in elderly patients after heart surgeryunder CPB.Results The comparison in age,gender,smoking,drinking,diabetes and hypertension showed the difference had no statistical significance between 2 groups(P＞0.05).After the operation,ARDS was correlated to NYHA classification of heart function,intraoperative blood loss,intraoperative blood transfusion,CPB time and aortic occlusion time(P＜0.05).The results of Logistic regression analysis showed that NYHA classification of heart function,intraoperative blood loss,intraoperative blood transfusion,CPB time and aortic occlusion time all were risk factors for ARDS occurrence(P＜0.05).Conclusion NYHAclassification of heart function,intraoperative blood loss,intraoperative blood transfusion,CPB time and aortic occlusion time all are risk factors for ARDS occurrence in elderly patients after heart surgeryunderCPB.
维普
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