摘要
目的:探讨体外循环(CPB)心脏术后低蛋白血症发生的围术期危险因素。方法:回顾性分析2018年7月至2020年10月在我院择期行心脏手术的成人患者201例,比较术前、术后血清白蛋白(ALB)水平,按术后48 h内的最低血清ALB浓度分为低白蛋白血症组(≤35 g/L)和非低白蛋白血症组(>35 g/L),并对两组围术期危险因素进行单因素及多因素Logistic分析。结果:201例心脏病患者术后发生低蛋白血症55例,发生率为27.36%,无院内死亡。CPB术后低蛋白血症单因素分析提示年龄、性别、脂肪肝、术前ALB水平、CPB时间、主动脉阻断时间与术后发生低蛋白血症有关。多因素二元Logistic回归分析提示年龄(OR=1.052,95%CI:1.013~1.093,P=0.008)、CPB时间(OR=1.025,95%CI:1.003~1.048,P=0.029)是CPB心脏术后低蛋白血症的独立危险因素。低蛋白血症组术后气管带管时间(P=0.025)、术后住院时间(P=0.049)明显延长,术后肺部感染发生率明显升高(P<0.001)。结论:年龄、CPB时间是CPB心脏术后低蛋白血症的独立危险因素;术后低蛋白血症患者术后气管带管时间、术后住院时间明显延长,肺部感染发生率显著增加。
Objective: To investigate the risk factors of hypoproteinemia after cardiac surgery with cardiopulmonary bypass(CPB). Methods: A total of 201 adult patients undergoing elective cardiac surgery were analyzed retrospectively in our hospital from July 2018 to October 2020, and their demographic data and relevant clinical data were statistically analyzed. The preoperative and postoperative serum albumin(ALB) levels were compared. The patients were divided into hypoalbuminemia group(≤35 g/L) and non-hypoalbuminemia group(>35 g/L) according to the lowest serum ALB concentration within 48 hours after operation. Univariate and multivariate logistic analyses were performed for the risk factors. Results: There were 55 cases of hypoproteinemia in 201 patients with heart disease after operation, with an incidence of 27.36%. There was no in-hospital death. Univariate analysis of hypoproteinemia after CPB suggested that age, gender, fatty liver, preoperative ALB level, CPB time, and aortic cross-clamp time were statistically analyzed and associated with postoperative hypoproteinemia. Multivariate logistic regression analysis suggested that age(OR=1.052, 95%CI: 1.013~1.093, P=0.008) and CPB time(OR=1.025, 95%CI: 1.003~1.048, P=0.029) were independent risk factors for hypoproteinemia after cardiac surgery with CPB. In the hypoproteinemia group, the postoperative tracheal intubation time(P=0.025) and postoperative hospital stay(P=0.049) were significantly prolonged, and the incidence of postoperative pulmonary infection was significantly increased(P<0.001). Conclusion: Age and CPB time are independent risk factors of hypoproteinemia after cardiac surgery with CPB. The postoperative tracheal intubation time and postoperative hospital stay of patients with postoperative hypoproteinemia were significantly prolonged, and the incidence of pulmonary infection was significantly increased.
作者
吴文军
赖应龙
梅波
何光杰
谭雄
金伟涛
张建
WU Wenjun;LAI Yinglong;MEI Bo;HE Guangjie;TAN Xiong;JIN Weitao;ZHANG Jian(Department of Cardiovascular Surgery,Daping Hospital of Army Medical University,Chongqing,400042,China;Department of Cardiovascular Surgery,Affiliated Hospital of North Sichuan Medical College)
出处
《临床心血管病杂志》
CAS
北大核心
2021年第7期659-663,共5页
Journal of Clinical Cardiology
关键词
体外循环
心脏手术
低蛋白血症
危险因素
cardiopulmonary bypass
cardiac surgery
hypoproteinemia
risk factors
