Dong Xiu-hua, Lu Jia-kai, Qing En-ming, Wang Yi-jun, Wang Cheng-bin, Zhang Liang, Liu Ling
Department of Anesthesiology, Anzhen Hospital, Capital Medical University, Beijing 100029, China.
Zhonghua Yi Xue Za Zhi. 2012 May 22;92(19):1321-4.
To investigate the risk factors of postoperative hemodialysis in patients undergoing off-pump coronary artery bypass grafting (OPCAB).
The perioperative data of 2379 consecutive patients undergoing OPCAB from November 2007 to February 2009 were analyzed retrospectively. Patients were divided into dialysis group and non-dialysis group according to their use of hemodialysis therapy or not.
Fifty-four patients experienced hemodialysis postoperatively. The incidence of hemodialysis was 2.3%, the mortality rate of dialysis group and non-dialysis group was 18.5% and 0.9% respectively. Univariate analysis showed that these factors significantly related with the postoperative dialysis:intraoperative ventricular fibrillation, emergent cardiopulmonary bypass, preoperative atrial fibrillation, intraoperative atrial fibrillation, preoperative renal dysfunction, intraoperative high-dose adrenaline usage, ventricular aneurysm, combined valvular disease, hypertension, age and numbers of grafting vessels. Multivariate logistic regression showed that intraoperative ventricular fibrillation, intraoperative high-dose adrenaline usage, hypertension, age and the numbers of grafting vessel were the risk factors of postoperative hemodialysis for patients undergoing OPCAB surgery.
Intraoperative ventricular fibrillation, intraoperative high-dose adrenaline usage, hypertension, age and the numbers of grafting vessels were the independent predictors of postoperative hemodialysis in patients undergoing OPCAB surgery.
探讨非体外循环冠状动脉搭桥术(OPCAB)患者术后血液透析的危险因素。
回顾性分析2007年11月至2009年2月连续2379例行OPCAB手术患者的围手术期资料。根据患者是否使用血液透析治疗将其分为透析组和非透析组。
54例患者术后进行了血液透析。血液透析发生率为2.3%,透析组和非透析组的死亡率分别为18.5%和0.9%。单因素分析显示,这些因素与术后透析显著相关:术中室颤、急诊体外循环、术前房颤、术中房颤、术前肾功能不全、术中高剂量肾上腺素使用、室壁瘤、合并瓣膜病、高血压、年龄和移植血管数量。多因素logistic回归显示,术中室颤、术中高剂量肾上腺素使用、高血压、年龄和移植血管数量是OPCAB手术患者术后血液透析的危险因素。
术中室颤、术中高剂量肾上腺素使用、高血压、年龄和移植血管数量是OPCAB手术患者术后血液透析的独立预测因素。