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鸦片成瘾对冠状动脉搭桥手术后短期术后结局的影响:一项前瞻性观察队列研究。

The effect of opium addiction on short-term postoperative outcomes after coronary artery bypass graft surgery: A prospective observational cohort study.

作者信息

Habibi Mohammad Reza, Alipour Abbas, Soleimani Aria, Kiabi Farshad Hasanzadeh, Habibi Ali, Emami Zeydi Amir

机构信息

Department of Anesthesiology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.

Department of Community Medicine, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.

出版信息

Biomedicine (Taipei). 2020 Dec 1;10(4):23-28. doi: 10.37796/2211-8039.1042. eCollection 2020.

Abstract

INTRODUCTION

Opium addiction has been recently suggested as a potential risk factor for the occurrence of perioperative complications in patients undergoing coronary artery bypass graft (CABG) surgery. The aim of this study was to evaluate whether opium addiction can potentially affect patients' short-term postoperative outcomes after CABG surgery.

MATERIAL AND METHODS

In a prospective observational cohort study, all consecutive patients who were scheduled for first-time isolated elective on pump CABG surgery were screened during the study period for opium addiction. The study was carried out between September 2015 and November 2016 at Mazandaran Heart Center, Sari, Iran. A total number of 228 patients [110 opium addicted (OA) and 118 non-addicted (NA)] were screened and included. All patients were evaluate, in terms of short-term postoperative outcomes, until hospital discharge or death.

RESULTS

In the OA patients, the mean amount of estimated postoperative bleeding was significantly more than NA patients (535 ± 304.75 ml vs. 463.56 ± 209.77; P = 0.04). Mean ventilation time were significantly longer in the OA patients than in the NA (9.9 days vs. 8.66 days, P = 0.02). The mean duration of postoperative hospital stay was two days longer in the OA (10.83 days vs. 8.34 days, P < 0.001). Also, the mean use of packed cell during surgery and incidence of postoperative atrial fibrillation were higher in the OA patients than NA (P = 0.005).

CONCLUSION

The results of our study provide strong evidence that the opium addiction should be considered as a risk factors for developing perioperative complications, including higher mean postoperative bleeding, need for intraoperative packed red blood cell transfusion, ventilation time and length of hospital stay, in patients undergoing CABG surgery.

摘要

引言

近期研究表明,鸦片成瘾可能是冠状动脉搭桥术(CABG)患者围手术期并发症发生的潜在危险因素。本研究旨在评估鸦片成瘾是否会对CABG术后患者的短期预后产生潜在影响。

材料与方法

在一项前瞻性观察队列研究中,于研究期间对所有计划首次进行择期体外循环CABG手术的连续患者进行鸦片成瘾筛查。该研究于2015年9月至2016年11月在伊朗萨里的马赞德兰心脏中心开展。共筛查并纳入了228例患者[110例鸦片成瘾(OA)患者和118例非成瘾(NA)患者]。所有患者均接受短期术后预后评估,直至出院或死亡。

结果

OA患者术后估计平均出血量显著多于NA患者(535±304.75毫升对463.56±209.77毫升;P=0.04)。OA患者的平均通气时间显著长于NA患者(9.9天对8.66天,P=0.02)。OA患者术后平均住院时间长两天(10.83天对8.34天,P<0.001)。此外OA患者术中浓缩红细胞的平均使用量及术后房颤发生率均高于NA患者(P=0.005)。

结论

我们的研究结果提供了有力证据,表明鸦片成瘾应被视为CABG手术患者发生围手术期并发症的危险因素,包括术后平均出血量增加、术中需要输注浓缩红细胞、通气时间延长和住院时间延长。

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