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中性粒细胞与淋巴细胞比值对冠状动脉旁路移植术后病程的影响。

The effect of neutrophil-lymphocyte ratio on the postoperative course of coronary artery bypass graft surgery.

出版信息

Turk J Med Sci. 2018 Oct 31;48(5):1036-1040. doi: 10.3906/sag-1804-94.

Abstract

Background/aim: Recovery after coronary artery bypass graft surgery (CABG) can be complicated, leading to postoperative morbidity. The roles of hematologic and surgery-related parameters are important. The main purpose of this study is to determine the role of preoperative and postcardiopulmonary bypass neutrophil/lymphocyte ratio (NLR) on postoperative recovery. Materials and methods: Sixty-two patients aged between 41 and 80 years, scheduled for elective CABG surgery with ASA I-II risk and without a history of preoperative blood transfusion, were included in the study. Three patients were excluded due to their need for additional surgical procedures other than CABG. The patients were divided into two groups that were formed depending on preoperative NLR cut-off values below (Group 1, n = 37) and above 4 (Group 2, n = 22). Postoperative data such as length of stay in the hospital and in the intensive care unit (ICU), chest tube drainage, and incidence of atrial fibrillation were recorded for all patients. Results: Preoperative NLR was significantly lower in Group 1 (P < 0.0001), and there was no significant difference between the groups in terms of postoperative NLR (P = 0.217) when the two groups were compared. The patients in Group 2 had a longer length of stay in the ICU (P = 0.035) and in the hospital (P = 0.034). There was a positive correlation between preoperative NLR and length of stay in the ICU (P = 0.017) and the hospital (P = 0.014). No statistically significant differences in postoperative drainage or incidence of postoperative atrial fibrillation were detected between the two groups. Conclusion: The results of our study demonstrate that the postoperative NLR may be useful to predict the length of hospital and ICU stays and help the management of follow-up and treatment processes in patients undergoing CABG surgery.

摘要

背景/目的:冠状动脉旁路移植术(CABG)后的恢复可能会很复杂,导致术后发病率增加。血液学和手术相关参数的作用很重要。本研究的主要目的是确定体外循环前后中性粒细胞/淋巴细胞比值(NLR)对术后恢复的作用。

材料和方法

62 名年龄在 41 至 80 岁之间的患者,拟行择期 CABG 手术,ASA I-II 级,无术前输血史,纳入本研究。因需要除 CABG 以外的其他手术而排除 3 例患者。根据术前 NLR 截断值将患者分为两组,低于 4(组 1,n = 37)和高于 4(组 2,n = 22)。记录所有患者的术后数据,如住院和重症监护病房(ICU)的停留时间、胸腔引流管和心房颤动的发生率。

结果

组 1 的术前 NLR 明显较低(P < 0.0001),当比较两组时,两组之间的术后 NLR 无显著差异(P = 0.217)。组 2 的 ICU(P = 0.035)和住院时间(P = 0.034)较长。术前 NLR 与 ICU (P = 0.017)和住院时间(P = 0.014)呈正相关。两组间术后引流或术后心房颤动发生率无统计学差异。

结论

我们的研究结果表明,术后 NLR 可能有助于预测住院和 ICU 停留时间,并有助于管理 CABG 术后的随访和治疗过程。

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