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冠状动脉搭桥手术后,术中变量是否会对气管拔管时间产生影响?

Do intraoperative variables have an effect on the timing of tracheal extubation after coronary artery bypass graft surgery?

作者信息

Walthall Helen, Ray Steve

机构信息

School of Health Care/School of Biological and Molecular Sciences, Oxford Brookes University, Oxford, United Kingdom.

出版信息

Heart Lung. 2002 Nov-Dec;31(6):432-9. doi: 10.1067/mhl.2002.129446.

Abstract

OBJECTIVE

The purpose of this study was to investigate whether any intraoperative variable had a significant effect on extubation time after coronary artery bypass graft surgery.

DESIGN

Study design was a retrospective study.

SETTING

Study took place in 1 cardiac center in the United Kingdom that had 1000 cases per year.

SUBJECTS

Eighty-nine patients had coronary artery bypass graft surgery in the first 6 months of 1998 performed by one consultant cardiac surgeon.

OUTCOME MEASURES

Study measures included intraoperative variables (number of vessels grafted, time on cardiopulmonary bypass [CPB], length of the operation, use of internal mammary artery) and extubation time.

RESULTS

Mean extubation time was 4.97 hours. On analysis via linear regression no intraoperative variables were found to be statistically significant (P = .05) to extubation time.

CONCLUSION

This study identified that early extubation can be achieved safely. Although no variable was found to have a significant effect on extubation time, the relationship between CPB and extubation may have been attributed to the low mean CPB time within the study (49.1 minutes). The relationship between cardiac status, ischemia, and the timing of extubation does warrant additional exploration.

摘要

目的

本研究旨在调查冠状动脉搭桥手术后,是否有任何术中变量对拔管时间有显著影响。

设计

研究设计为回顾性研究。

地点

研究在英国的1个心脏中心进行,该中心每年有1000例病例。

研究对象

1998年上半年,由1位心脏外科顾问医生为89例患者实施了冠状动脉搭桥手术。

观察指标

研究指标包括术中变量(移植血管数量、体外循环[CPB]时间、手术时长、乳内动脉的使用情况)和拔管时间。

结果

平均拔管时间为4.97小时。通过线性回归分析,未发现任何术中变量对拔管时间有统计学意义(P = .05)。

结论

本研究表明,早期拔管可安全实现。虽然未发现任何变量对拔管时间有显著影响,但体外循环与拔管之间的关系可能归因于研究中较低的平均体外循环时间(49.1分钟)。心脏状态、缺血与拔管时机之间的关系确实值得进一步探讨。

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