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体重指数对不停跳冠状动脉搭桥手术术后并发症的影响

Effect of Body Mass Index on Postoperative Complications in Beating Coronary Artery Surgery.

作者信息

Sabzi Feridoun, Faraji Reza

机构信息

Preventive Cardiovascular Research Centre Kermanshah, Kermanshah University of Medical Sciences, Kermanshah, Iran.

出版信息

Ethiop J Health Sci. 2016 Nov;26(6):509-516. doi: 10.4314/ejhs.v26i6.2.

Abstract

BACKGROUND

Body Mass Index (BMI) is considered as an important risk factor in cardiovascular surgery. We designed a study for the evaluation of perioperative complications related to BMI in patients who underwent off-pump coronary artery bypass grafting (OPCAB).

METHODS

We studied 1120 consecutive patients who underwent OPCAB between January 2008 and December 2011 in Imam Ali Hospital, Kermanshah, Iran. Patients were divided into four groups according to BMI: underweight/low BMI (< 18.5 kg/m), healthy weight (between 18.5 kg/m and 24.9 kg/m), overweight/high BMI (between 25 kg/m and 30 kg/m), and obese/very high BMI (> 30 kg/m).

RESULTS

In multivariable regression analysis, an important correlation between the underweight/low BMI group and mortality was observed (p=). Postoperative stroke, postoperative atrial fibrillation (AF) and intra-aortic balloon pump (IABP) use were not associated with BMI. In linear regression analysis, significant correlations between low BMI, reintubation, ICU stay time and intubation time were found. Re-exploration for bleeding was significantly correlated with having a low or high BMI.

CONCLUSION

Having a low BMI (which is association with malnutrition and respiratory muscles weakness) was significantly associated with reintubation, prolonged intubation time and ICU stay time. The obese group was also associated with postoperative atelectasia and fever.

摘要

背景

体重指数(BMI)被认为是心血管手术中的一个重要风险因素。我们设计了一项研究,以评估非体外循环冠状动脉搭桥术(OPCAB)患者中与BMI相关的围手术期并发症。

方法

我们研究了2008年1月至2011年12月期间在伊朗克尔曼沙赫伊玛目阿里医院连续接受OPCAB手术的1120例患者。根据BMI将患者分为四组:体重过轻/低BMI(<18.5kg/m²)、健康体重(18.5kg/m²至24.9kg/m²之间)、超重/高BMI(25kg/m²至30kg/m²之间)和肥胖/极高BMI(>30kg/m²)。

结果

在多变量回归分析中,观察到体重过轻/低BMI组与死亡率之间存在重要相关性(p=)。术后中风、术后房颤(AF)和主动脉内球囊泵(IABP)的使用与BMI无关。在线性回归分析中,发现低BMI与再次插管、ICU住院时间和插管时间之间存在显著相关性。因出血再次手术与低BMI或高BMI显著相关。

结论

低BMI(与营养不良和呼吸肌无力相关)与再次插管、插管时间延长和ICU住院时间显著相关。肥胖组还与术后肺不张和发热有关。

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