被动吸烟对冠状动脉搭桥术后低氧血症的影响

doi:10.3969/j.issn.1674-490X.2018.01.006

摘要/Abstract

摘要： 目的评估被动吸烟对冠状动脉旁路移植术(coronary artery bypass grafting,CABG)后低氧血症的影响。方法选取拟体外循环下CABG患者126人,分为不吸烟组和被动吸烟组,后者根据每周暴露时间进一步分为3个亚组:<10 h、10~20 h、>20 h 组。首先监测CABG术后各组低氧血症发病情况,其次记录各组患者的机械通气时间和ICU停留时间。应用Logistic分析观察被动吸烟情况与术后低氧血症的关系。结果 4组低氧血症发生率比较,差异有统计学意义(P<0.01);各组低氧血症发生率分别为20.00%、 25.93%、55.56%、59.26%,依次增高;被动吸烟组机械通气时间和ICU停留时间长于不吸烟组,差异有统计学意义(P<0.05)。结论被动吸烟是CABG术后低氧血症的危险因素,被动吸烟增加CABG术后低氧血症发生率,延长术后机械通气时间和ICU停留时间。随着暴露时间增加,低氧血症发病率呈递增趋势。

关键词: 被动吸烟, 冠状动脉旁路移植术, 体外循环, 低氧血症

Abstract: Objective To evaluate the effects of passive smoking on postoperative hypoxemia(POH)of on-pump coronary artery bypass grafting surgery patients. Methods 126 patients were undergone on-pump CABG surgery.The patients were divided into non-smokers and passive smokers, the latter were further divided into the following 3 sub-groups according to exposure time:<10 h per week,10-20 h and >20 h per week. The primary outcome measure was the incidence of POH after CABG surgery in each group. Secondary outcomes included length of postoperative mechanical ventilation and ICU stay. Logistic analysis was used to observe the relationship between passive smoking and postoperative hypoxemia. Results There was a significant difference in the incidence of POH in the 4 groups(P<0.01),The incidence of hypoxemia(20.00%, 25.93%, 55.56% and 59.26%, respectively)in each group increased successively. The length of postoperative mechanical ventilation and ICU stay were longer in passive smokers than that in non-smokers(P<0.05). Conclusion Passive smoking is a risk factor of POH after CABG surgery, passive smoking can increase POH incidence after on-pump CABG surgery,and it also can prolong the length of postoperative mechanical ventilation and ICU stay. With the increase of exposure time, the incidence of POH also shows increasing trend.

Key words: passive smoking, coronary artery bypass grafting, on-pump, hypoxemia

中图分类号:

栗志勇,常俊伟,张悟麟,刘海燕. 被动吸烟对冠状动脉搭桥术后低氧血症的影响[J]. 医学研究与教育, 2018, 35(1): 31-36.

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