中国血液净化

中国血液净化 ›› 2016, Vol. 15 ›› Issue (12): 656-659.doi: 10.3969/j.issn.1671-4091.2016.12.002

• 临床研究 • 上一篇    下一篇

终末期肾病透析依赖患者冠状动脉旁路移植术围术期和近中期随访结果

李西慧,李岩,张思宇   

  1. 北京大学第一医院心脏外科
  • 收稿日期:2016-06-15 修回日期:2016-09-27 出版日期:2016-12-12 发布日期:2016-12-05
  • 通讯作者: 李西慧 heart2000@163.com E-mail:heart2000@163.com

Follow-up study of the peri-operative, short-term and medium-term outcomes after coronary artery bypass grafting in patients with dialysis-dependent end-stage renal disease

  • Received:2016-06-15 Revised:2016-09-27 Online:2016-12-12 Published:2016-12-05

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摘要： 目的随访终末期肾脏病(end stage renal disease，ESRD)透析依赖患者冠状动脉旁路移植术(coronary artery bypass grafting，CABG)围术期和近中期生存率，并分析相关影响因素。方法回顾性分析26 例透析依赖的ESRD 患者行CABG 围术期和1、3、5 年的生存率。生存率使用Kaplan-Meier生存曲线表示，生存率影响因素使用Log Rank(Mantel-Cox)分析。结果围术期死亡3 例，死亡率11.5%。出院患者23 例，随访时间(2.9±2.4)年。1 年生存率90.0%，3 年生存率没有该时间点的用2 年近似76.9%，5 年生存率54.7%。高血压是影响术后生存率的风险因素(Log Rank χ2=5.870，P=0.015)。结论ESRD 患者行CABG 围术期死亡率高，术后近中期生存率不太满意，高血压是影响患者术后生存的危险因素。

关键词: 终末期肾病, 透析依赖, 冠状动脉旁路移植术, 生存率

Abstract: Objective To follow up the peri-operative, short-term and medium-term outcomes after coronary artery bypass grafting (CABG) and to analyze the relevant influencing factors in patients with dialysisdependent end-stage renal disease (ESRD). Methods The survival rate during perioperative period and after CABG surgery for 1, 3 and 5 years in 26 dialysis-dependent ESRD patients undergoing CABG were retrospectively analyzed. Kaplan-Meier survival curve was used to show survival rate, and Log-rank (Mantel-Cox) test was used for identifying relevant influencing factors. Results Three patients died during perioperative period
(mortality 11.5%), and 23 patients discharged from the hospital successfully. The average follow-up time is 2.9±2.4 years. The survival rate is 90% in one year, 76.9% in 2 years after surgery (there is no survival rate in three years after surgery, approximate 2-year survival rate is then used), and 54.7% in 5 years after surgery. Log-rank(Mantel-Cox) test shows that hypertension is the only risk factor for postoperative survival rate (χ2=5.870, P=0.015). Conclusions Perioperative mortality after CABG in dialysis-dependent ESRD patients undergoing CABG is high, and the short and medium term survival rates (1 year, 2 years, 3 years after surgery) are not satisfactory. Hypertension is the only risk factor influencing postoperative survival rate.

Key words: end stage renal disease, dialysis-dependent, coronary artery bypass grafting, survival rate