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外科研究与新技术 ›› 2014, Vol. 3 ›› Issue (2): 104-107.

• 论著 • 上一篇    下一篇

27例冠状动脉旁路移植术死亡病例临床分析

张杨杨   

  1. 南京医科大学第一附属医院,心胸外科
  • 收稿日期:2014-06-16 修回日期:2014-06-16 出版日期:2014-06-28 发布日期:2014-07-22
  • 通讯作者: 张杨杨 E-mail:zhangyangyang_md@sina.com

Clinical analysis of 27 death cases undergoing isolated coronary artery bypass grafting

  • Received:2014-06-16 Revised:2014-06-16 Online:2014-06-28 Published:2014-07-22

摘要: 目的 探讨冠状动脉旁路移植术(coronary artery bypass grafting ,CABG)院内死亡病例相关危险因素。 方法 回顾性分析27例单纯CABG死亡病例临床资料,应用中国冠状动脉旁路移植手术风险评估系统(Sino system for coronary operative risk evaluation,SinoSCORE)进行手术风险评估,对致死性并发症、死亡时间、临床危险因素等进行统计学分析。结果 1146例CABG死亡率2.36%,SinoSCORE评估低危6例,中危5例,高危16例。术中死亡3例,手术48h内死亡5例,手术48h后死亡19例。手术48h内死亡原因为循环衰竭,手术48h后死亡原因为肺功能衰竭、肾功能衰竭等引起的多脏器功能衰竭。高龄女性死亡患者多因肺部感染引起肺功能衰竭。结论 SinoSCORE手术风险评估对手术结果有预测作用,心、肺、脑功能衰竭是主要死亡原因。 CABG围手术期应采取积极有效的预防和治疗措施,根据患者的特点个性化治疗。

Abstract: Objective To explore the risk factors correlated with post CABG (coronary artery bypass grafting)inpatient mortalitycases. Methods Data obtained from27clinical cases was first evaluated using SinoSCORE to justify surgical risks and then was analyzed with retrospective methodology.Statistical analysis was employed to analyze fatal complication, death time, and clinical risk factors. Results Atotal of 1146 cases was analyzed. Results from SinoSCORE evaluation showed that 6 cases were categorized as low risk level, while 5 were within moderate level, and 16 cases at a high risk level. Among 1146 cases, a 2.36% mortality rate was detected. Additionally, 3 cases occurred during the surgery, 5 cases occurred within 48h after the surgery (caused by circulatory failure), and 19 cases occurred after 48h of the surgery (caused bymultiple organ failure due to functional failure in both lung and renal). The main reason in elder women death cases was due to lung function failure caused by pulmonary infection. Conclusion TheSinoSCOREevaluation system provided indicated a predictive effect for the surgical results. The main reason of deaths was caused by the functional failure of heart, lung and cerebrum. Patient based precaution should be aware during the CABG perioperative period in order to provide individualized treatment.

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