Nghiên cứu các yếu tố dự báo hội chứng cung lượng tim thấp sau phẫu thuật van tim

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Tác giả: Thanh Luan Nguyen

Ngôn ngữ: Vie

Ký hiệu phân loại:

Thông tin xuất bản: Phẫu thuật Tim mạch và Lồng ngực Việt Nam 2023

Mô tả vật lý: 45427

Bộ sưu tập: Metadata

ID: 406771

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Chủ đề

Nghiên cứu mô tả cắt ngang trên bệnh nhân phẫu thuật van tim tại Khoa Gây mê Tim mạch - Trung tâm Tim mạch - Bệnh viện Trung ương Huế từ tháng 2/2022 đến tháng 7/2022. LCOS là biến phụ thuộc và biến độc lập được chia làm 3 nhóm trước mổ, trong mổ và sau phẫu thuật. Số liệu được xử lý bằng phần mềm R4.2.2. Sử dụng hồi quy logistic đơn biến để xác định các yếu tố tiên lượng độc lập. Kết quả: Nghiên cứu smdy trên 60 bệnh nhân sau phẫu thuật van tim cho thấy: LCOS sau phẫu thuật van tim có tỷ lệ là 28,3% với thời gian trung bình là 5,88 giờ sau phẫu thuật. Qua phân tích hồi quy logistic đơn biến, kết quả tìm thấy các yếu tố tiên lượng độc lập bao gồm: EF <
=40% tại các thời điểm trước mổ (OR=12,9, KTC 95% 1,73 - 26,5), EF Oh (OR) =2,3, KTC 95% 2,4-8,9 ), EF 4h (OR=2,9, 95%CI 1,9-6,7), EF 24h (OR=1,9, 95%CI 1,5-9,5), tiết sữa tại Oh thời điểm hậu phẫu (OR=1,81, 95%CI 1,25-2,8), 411 (OR=1,41, KTC 95% 1,13-1,85), 8 giờ (OR=1,38, KTC 95% 1,14-1,73), 12 giờ (OR=1,35, KTC 95% 1,11- 1,72), creatinine lúc 24 giờ sau phẫu thuật (OR =1,02, KTC 95% 1,01-1,04), điều chỉnh theo tuần hoàn ngoài cơ thể (OR=1,02, KTC 95% 1,02-1,04), thời gian kẹp động mạch chủ (OR=1,2, KTC 95% 1,1-1,2). Kết luận: Hội chứng cung lượng tim thấp là một trong những biến chứng nặng sau phẫu thuật van tim, việc phát hiện sớm và điều trị kịp thời sẽ giảm nguy cơ tử vong cho bệnh nhân. Kết quả smdy cho thấy nhiều yếu tố trước, trong và sau phẫu thuật là những yếu tố tiên lượng độc lập cho LCOS sau phẫu thuật., Tóm tắt tiếng anh, A cross-sectional descriptive smdy on patients undergoing valvular heart surgery at the Cardiovascular Anesthesiology Department - Cardiovascular Center - Hue Central Hospital horn February 2022 to July 2022. LCOS is the dependent variable and the independent variable was divided into three groups before surgery, during surgery and after surgery. The data were processed by software R4.2.2. Using univariate logistic regression to identify independent prognostic factors. Results: A smdy on 60 patients after heart valve surgery showed that: LCOS after heart valve surgery has a rate of 28.3% with an average time of 5.88 hours after surgery. Through univariate logistic regression analysis, the results found independent prognostic factors including: EF <
=40% at preoperative time points (OR=12.9, 95%CI 1.73 - 26.5), EF Oh (OR) =2.3, 95%CI 2.4-8.9), EF 4h (OR=2.9, 95%CI 1.9-6.7), EF 24h (OR=1.9, 95%CI 1.5-9.5), lactate at Oh postoperative time (OR=1.81, 95%CI 1.25-2.8), 411 (OR=1.41, 95%CI 1.13-1.85), 8h (OR=1.38, 95%CI 1.14-1.73), 12h (OR=1.35, 95%CI 1.11- 1.72), creatinine at 24 h after surgery (OR=1.02, 95%CI 1.01-1.04), tune to extracorporeal circulation (OR=1.02, 95%CI 1.02-1.04), time to clamp aorta (OR=1.2, 95%CI 1.1-1.2). Conclusion: Low cardiac output syndrome is one of the serious complications after heart valve surgeiy, early detection and timely treatment reduce the risk of death for patients. The smdy showed that many factors before, during and after surgery are independent prognostic factors for LCOS after surgery.

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