2023 年第 5 期 第 18 卷

低射血分数非体外循环冠状动脉旁路移植术患者围手术期积极康复治疗的效果

Effect of perioperative active rehabilitation treatment on patients with low ejection fraction undergoing off-pump coronary artery bypass grafting

作者：陈秀梅张俐鹏黄鑫许妍琦张帆王雪鸽胡晓鸿李海洋

英文作者：Chen Xiumei Zhang Lipeng Huang Xin Xu Yanqi Zhang Fan Wang Xuege Hu Xiaohong Li Haiyang

单位：首都医科大学附属北京安贞医院心脏外科，北京100029

英文单位：Department of Cardiac Surgery Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

关键词：低射血分数；冠状动脉旁路移植术；围手术期；康复治疗

英文关键词：Lowejectionfraction;Coronaryarterybypassgrafting;Perioperativeperiod;Rehabilitationtreatment

• 摘要：

• 目的 探讨围手术期积极康复治疗对低射血分数非体外循环冠状动脉旁路移植术（OPCABG）患者院内死亡率和术后并发症发生率的影响。方法 选取2018年5月至2020年5月在首都医科大学附属北京安贞医院行OPCABG患者704例，其中344例低射血分数（左心室射血分数≤40％）患者设为观察组，360例射血分数正常患者设为对照组。对照组采用一般护理策略；观察组在对照组基础上采用围手术期积极康复治疗。比较2组手术相关资料、院内死亡率和术后并发症发生率。结果  2组患者完全血运重建、采用乳内动脉、二次插管、体外膜氧合、主动脉内球囊反搏比例及手术时间比较，差异均无统计学意义（均P＞0.05）。2组术后各有4例患者发生了院内死亡，2组院内死亡率、术后并发症发生率比较差异均无统计学意义（均P＞0.05）。观察组因心血管事件再入院比例高于对照组［14.0%(48/344)比7.8%(28/360)］（P=0.037）。结论   对低射血分数OPCABG患者实施积极有效的围手术期康复治疗后，其院内死亡率和术后并发症发生率与正常射血分数患者相当。

• Objective  To investigate the effect of perioperative active rehabilitation treatment on the hospital mortality and postoperative complications in patients with low ejection fraction undergoing off-pump coronary artery bypass grafting (OPCABG) . Methods From May 2018 to May 2020, 704 patients with OPCABG in Beijing Anzhen Hospital, Capital Medical University were selected, including 344 patients with low ejection fraction (left ventricular ejection fraction ≤ 40%) as the observation group and 360 patients with normal ejection fraction as the control group. The control group adopted general nursing strategy, and the observation group was treated with perioperative active rehabilitation treatment on the basis of the control group. The operation related data, hospital mortality and postoperative complications were compared between the two groups. ResultsThere were no significant differences between the two groups in the proportions of complete revascularization, the use of internal mammary artery, secondary intubation, extracorporeal membrane oxygenation, intra-aortic balloon counterpulsation and operation time (all P＞0.05). There were 4 patients in each group who died in hospital after operation. There were no significant differences between the two groups in hospital mortality and postoperative complications (both P>0.05). The proportion of readmission due to cardiovascular events in the observation group was higher than that in the control group ［14.0%(48/344) vs 7.8%(28/360)］(P=0.037). Conclusions After active and effective perioperative rehabilitation treatment for OPCABG patients with low ejection fraction, there is no significant difference in hospital mortality and postoperative complication rate by comparing with patients with normal ejection fraction.