摘要
目的探讨冠状动脉旁路移植术（CABG）后住重症监护病房（ICU）时间延迟的危险因素，为制定CABG术后住ICU时间延迟的防治策略和措施提供依据。方法采用回顾性调查方法，选择宜昌市第一人民医院重症医学科2008年1月至2012年1月CABG术后全部患者病历资料进行分析。以术后住ICU时间〉3d者作为观察组，以术后住ICU时间〈3d者作为对照组；对两组患者潜在的危险因素进行对比分析，并采用非条件logistic多元回归分析判断影响CABG术后住ICU时间延迟的独立危险因素。结果共收治CABG术后患者68例，其中住ICU时间延迟者24例，发生率35．29％。单因素分析结果显示：术后低心排、心律失常、术后呼吸衰竭、术后急性肾衰竭、急诊手术及左房内径为CABG术后住ICU时间延迟的危险因素。Logistic多因素回归分析显示，仅有术后呼吸衰竭[优势比（OR）=6．865，95％可信区间（95％CI）为1．322～35．559]为CABG术后住ICU时间延迟的独立危险因素（P〈0．05）。结论术后呼吸衰竭是CABG术后住ICU时间延迟的独立危险因素。对CABG患者危险因素的监控，可减少CABG术后患者住ICU的时间。
Objective To investigate the risk factors of prolonged intensive care unit （ICU） stay following coronary artery bypass grafting （CABG）, and to provide a reference for effective control measure. Methods A retrospective study was conducted. All data of patients with post CABG admitted to the Department of Critical Care Medicine of the First People＇s Hospital in Yichang from January 2008 to January 2012 were retrospectively analyzed. The CABG patients staying in ICU more than 3 days served as observation group, and the patients staying in ICU less than 3 days were the control group. Potential risk factors in both groups were compared, and muhivariable non-condition logistic regressions analysis was adopted to determine the independent risk factors which resulted in prolonged stay in ICU after CABG. Results Sixty-eight patients underwent CABG were analyzed retrospectively. Twenty-four cases （35.29%） had prolonged stay in ICU after CABG. Univariate analysis showed that the risk factors of prolonged stay in ICU after CABG were low cardiac output, arrhythmia, postoperative respiratory failure, postoperative acute renal failure, emergency operation, and left atrial inner diameter. The muhivariable logistic regression analysis showed that the independent risk factor of prolonged stay in ICU after CABG was the postoperative respiratory failure [ odds ratio （OR） = 6.856, 95% confidence interval （95%CI） 1.322 - 35.559, P〈0.05]. Conclusions The independent risk factor of prolonged stay in ICU after CABG was postoperative respiratory failure. By monitoring the risk factors, duration of stay in ICU after CABG can be decreased.
出处
《中华危重病急救医学》
CAS
CSCD
北大核心
2013年第2期109-111,共3页
Chinese Critical Care Medicine
