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接受冠状动脉搭桥手术的慢性阻塞性肺疾病患者的动脉血气分析

Arterial Blood Gas Analysis in Chronic Obstructive Pulmonary Disease Patients Undergoing Coronary Artery Bypass Surgery.

作者信息

İlhan Sami, Günay Rafet, Özkan Sevil, Güvenç Tolga Sinan, Yurtsever Nurgül

机构信息

Clinic of Chest Diseases, Dr. Siyami Ersek Chest Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey.

Clinic of Cardiovascular Surgery, Dr. Siyami Ersek Chest Cardiovascular Surgery Training and Reseacrh Hospital, İstanbul, Turkey.

出版信息

Turk Thorac J. 2016 Jul;17(3):93-99. doi: 10.5578/ttj.30503. Epub 2016 Jul 1.

Abstract

OBJECTIVES

We aimed to investigate the impact of arterial blood gas (ABG) on morbidity and mortality in chronic obstructive pulmonary disease (COPD) patients undergoing CABG surgery.

MATERIAL AND METHODS

The records for 75 COPD patients who underwent elective CABG surgery our institution clinic between November 2008 to 2011 and had a forced expiratory volume in 1 second (FEV)/forced vital capacity (FVC) ≤ 70% value in the pulmonary function tests (PFT) performed prior to the surgery were evaluated retrospectively. COPD patients were divided into two groups; Group 1; FEV ≥ 60% and Group 2; FEV ≤ 59%. Groups were compared for mortality and adverse events after identification of other preoperative and postoperative factors that could affect mortality and adverse events. An ABG was obtained immediately before and 3 to 6 hours after surgery to study the predictive value of ABG in seperate COPD groups.

RESULTS

There were no significant differences in patients with high partial pressure carbondioxide (PaCO) preoperative values compared to patients with normal values. Also there were no significant differences in patients with lower partial pressure of oxygen (PaO) preoperative values compared to patients with normal values in terms of mortality. Postoperative myocardial infarction (MI) was significantly higher in patients with low PaO values (p< 0.05).

CONCLUSION

In conclusion, in our study, there could not be found a relation between the degree of preoperative obstruction and mortality for COPD patients who underwent CABG surgery. ABG was not found useful for predicting mortality in COPD patients undergoing CABG surgery, but could be useful to predict postoperative MI in patients with COPD.

摘要

目的

我们旨在研究动脉血气(ABG)对接受冠状动脉旁路移植术(CABG)的慢性阻塞性肺疾病(COPD)患者发病率和死亡率的影响。

材料与方法

回顾性评估2008年11月至2011年在我院门诊接受择期CABG手术且术前肺功能测试(PFT)中1秒用力呼气量(FEV)/用力肺活量(FVC)≤70%的75例COPD患者的记录。COPD患者分为两组;第1组;FEV≥60%和第2组;FEV≤59%。在确定其他可能影响死亡率和不良事件的术前和术后因素后,比较两组的死亡率和不良事件。在手术前及手术后3至6小时立即采集ABG,以研究ABG在不同COPD组中的预测价值。

结果

术前二氧化碳分压(PaCO)高值患者与正常患者相比无显著差异。术前氧分压(PaO)低值患者与正常患者在死亡率方面也无显著差异。PaO低值患者术后心肌梗死(MI)显著更高(p<0.05)。

结论

总之,在我们的研究中,对于接受CABG手术的COPD患者,术前阻塞程度与死亡率之间未发现关联。ABG对预测接受CABG手术的COPD患者的死亡率无用,但可能有助于预测COPD患者术后MI。

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