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[1]叶晓芳 杨京华 武元星 朱光发.COPD患者冠状动脉旁路移植术后肺部感染的预后影响及危险因素分析[J].中华肺部疾病杂志,2023,(02):175-179.[doi:10.3877/cma.j.issn.1674-6902.2023.02.005 ]
　Ye Xiaofang,Yang Jinghua,Wu Yuanxing,et al.Prognostic influence and risk factors of pneumonia after coronary artery bypass transplantation in patients with COPD[J].,2023,(02):175-179.[doi:10.3877/cma.j.issn.1674-6902.2023.02.005 ]
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COPD患者冠状动脉旁路移植术后肺部感染的预后影响及危险因素分析(PDF)

《中华肺部疾病杂志》[ISSN:1006-6977/CN:61-1281/TN]

卷:
期数:
2023年02期
页码:
175-179
栏目:
论著
出版日期:
2023-04-20

文章信息/Info

Title:
Prognostic influence and risk factors of pneumonia after coronary artery bypass transplantation in patients with COPD
作者:
叶晓芳 杨京华 武元星 朱光发
100029 北京,首都医科大学附属北京安贞医院呼吸与危重症医学科
Author(s):
Ye Xiaofang;  Yang Jinghua;  Wu Yuanxing;  Zhu Guangfa.
Department of Respiratory and Critical Care Medicine, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute Heart, Lung and Blood Vessel Diseases, Beijing 100029, China
关键词:
肺部感染;  肺疾病; 慢性阻塞性;  冠状动脉旁路移植术;  第一秒用力呼气容积
Keywords:
Pulmonary infection;  Coronary artery bypass grafting;  Chronic obstructive pulmonary disease;  Forced expiratory volume in the first second
分类号:
R563
DOI:
10.3877/cma.j.issn.1674-6902.2023.02.005
摘要:
目的 分析慢性阻塞性肺疾病(chronic obstructive pulmonary disease, COPD)患者接受冠状动脉旁路移植术(coronary artery bypass grafting, CABG)术后发生肺部感染的危险因素及其对预后的影响。方法 回顾性分析2021年1月至2021年12月首都医科大学附属北京安贞医院收治的CABG手术的COPD患者临床资料,按照术后住院期间是否发生肺部感染,分为观察组75例及对照组143例,对其术前、术后的临床资料进行分析,以分析肺部感染的预后影响及危险因素。结果 共纳入218例患者,术后肺部感染的发生率为75例(34.40%)。观察组术后住院时间平均延长1.81 d(P<0.001); 30 d及1年病死率组间无统计学差异。多元二分类Logistic回归分析显示,第一秒用力呼气容积(FEV1%)与CABG术后肺部感染发生率负相关(OR=0.938,95%CI: 0.881～0.998,P<0.05),年龄≥65岁(OR=4.027,95%CI: 2.101～7.719,P<0.001)、FEV1≤60%(OR=9.255,95%CI: 2.328～36.794,P=0.002)是术后发生肺部感染的危险因素。结论 CABG术后发生肺部感染会延长住院时间,对30 d及1年病死率无影响。年龄≥65岁、FEV1≤60%是COPD患者CABG术后发生肺部感染的危险因素。
Abstract:
Objective To investigate the risk factors of pneumonia after coronary artery bypass grafting(CABG)in patients with chronic obstructive pulmonary disease(COPD)and its influence on prognosis. Methods The clinical data of COPD patients undergoing CABG surgery admitted to Beijing Anzhen Hospital Affiliated to Capital Medical University from January 2021 to December 2021 were retrospectively analyzed. According to whether postoperative pneumonia occurred during the postoperative hospitalization, the patients were divided into observation group 75 cases and control group 143 cases. The preoperative and postoperative clinical data were analyzed to explore the risk factors of pneumonia. Results A total of 218 patients were included, ranging in age from 45 to 76 years, with an average age of(64.81±7.72)years, including 149 males(68.35%). The incidence of postoperative pulmonary infection was 75 cases(34.40%). The average length of postoperative hospital stay in the observation group was extended by 1.81 days(P<0.001), but there was no significant difference in mortality at 30 days and within 1 year between the two groups. Multivariate binary Logistic regression analysis showed that FEV1% was negatively correlated with the incidence of postoperative pneumonia of CABG(OR=0.938, 95%CI: 0.881～0.998, P<0.05). Age ≥65 years old(OR=4.027, 95%CI: 2.101～7.719, P<0.001), forced expiratory volume in the first second(FEV1)≤60%(OR=9.255, 95%CI: 2.328～36.794, P=0.002)were risk factors for postoperative pneumonia. Conclusions Pulmonary infection after CABG surgery prolonged hospital stay and had no effect on 30 d and 1-year mortality. Age≥65 years and FEV1≤60% are risk factors for pulmonary infection after CABG in COPD patients.

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备注/Memo

备注/Memo:
通信作者: 朱光发, Email: gfzzhu6388@sina.com
更新日期/Last Update: 2023-04-20