术前 HbA1c 水平对冠状动脉旁路移植术后患者术后并发症发生的影响。
Influence of preoperative HbA1c levels on the occurrence of postoperative complications in patients undergoing coronary artery bypass grafting.
机构信息
Cardiovascular Surgery, Zibo Central Hospital, Zibo, 255036, Shandong, China.
Cardiovasology, Zibo Central Hospital, Zibo, 255036, Shandong, China.
出版信息
J Cardiothorac Surg. 2024 Oct 4;19(1):593. doi: 10.1186/s13019-024-02993-4.
OBJECTIVE
To explore the impact of preoperative HbA1c levels on postoperative complications in coronary heart disease patients undergoing coronary artery bypass grafting (CABG).
METHODS
From September 2020 to November 2022, 98 patients with coronary heart disease who were preparing to receive CABG treatment in a cardiac surgery department of a certain hospital were included in the study using the retrospective analysis. According to the preoperative serum hemoglobin A1C (HbA1c) test results, patients were divided into a low-level group (HbA1c < 5.7%, 20 cases), a medium level group (HbA1c: 5.7% ~ 7.0%, 59 cases), and a high level group (> 7%, 19 cases). The surgical outcomes and postoperative complications among the three groups were compared.
RESULTS
There was no statistically significant difference in the number of bypass grafts, mechanical ventilation time, and hospitalization time among the three groups of patients (P > 0.05). The high-level group stayed in the ICU longer than the other two groups, while the middle level group had a longer stay than the low-level group (P < 0.05). Within one year of postoperative follow-up, the occurrence of postoperative complications was 20.00%, 32.20%, and 47.37%, respectively, with no statistically significant difference (P > 0.05). Among them, the incidence of acute kidney injury in the high-level group was higher than that in the other groups (P < 0.05), but the correlation difference between the middle and low level groups is P > 0.05. The incidence of infection in the middle level group was higher than that in the low level group (P < 0.05), but the incidence of infection in the high and low level groups was P > 0.05 compared to the medium level group.
CONCLUSION
For patients with coronary heart disease undergoing CABG, the higher the preoperative HbA1c level, the longer their postoperative stay in the ICU, and the higher the risk of acute renal function damage.
目的
探讨术前糖化血红蛋白（HbA1c）水平对行冠状动脉旁路移植术（CABG）的冠心病患者术后并发症的影响。
方法
采用回顾性分析方法，选取 2020 年 9 月至 2022 年 11 月在某医院心脏外科准备行 CABG 治疗的 98 例冠心病患者，根据术前血清糖化血红蛋白（HbA1c）检测结果将患者分为低水平组（HbA1c＜5.7%，20 例）、中水平组（HbA1c：5.7%~7.0%，59 例）和高水平组（＞7%，19 例）。比较三组患者的手术结果和术后并发症。
结果
三组患者的旁路移植数量、机械通气时间和住院时间比较，差异均无统计学意义（P＞0.05）。高水平组患者在 ICU 停留时间长于其他两组，中水平组患者长于低水平组（P＜0.05）。术后 1 年随访期间，三组患者术后并发症发生率分别为 20.00%、32.20%和 47.37%，差异无统计学意义（P＞0.05）。其中，高水平组急性肾损伤发生率高于其他两组（P＜0.05），但中、低水平组间差异无统计学意义（P＞0.05）。中水平组感染发生率高于低水平组（P＜0.05），但高水平组与低水平组相比，感染发生率高于中水平组（P＞0.05）。
结论
对于行 CABG 的冠心病患者，术前 HbA1c 水平越高，术后 ICU 停留时间越长，肾功能损伤风险越高。
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