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جلد 25، شماره 11 - ( 11-1397 )                   جلد 25 شماره 11 صفحات 23-33 | برگشت به فهرست نسخه ها

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Askari B, Mehdizadeh H, koomasi S. Evaluation of determinants of mortality in patients undergoing coronary artery bypass graft surgery in Urmia Seyed-al-Shohada Heart Center . RJMS. 2019; 25 (11) :23-33
URL: http://rjms.iums.ac.ir/article-1-5337-fa.html
عسکری بهنام، مهدی زاده حمید، کوماسی صفا. بررسی عوامل تعیین‌کننده مرگ و میر بیماران به دنبال عمل جراحی بای پس عروق کرونر در بیمارستان سیدالشهداء ارومیه. مجله علوم پزشکی رازی. 1397; 25 (11) :23-33

URL: http://rjms.iums.ac.ir/article-1-5337-fa.html


دانشگاه علوم پزشکی ارومیه، ارومیه، ایران ، askaribehnam@ymail.com
چکیده:   (876 مشاهده)
زمینه و هدف: بیماری‌های قلبی - عروقی علت اصلی مرگ و میر در ایران و سایر کشورهای جهان است. در مورد عوامل خطر و علل مرگ و میر بیماران به دنبال عمل جراحی بای پس عروق کرونر (CABG- Coronary artery bypass grafting) اتفاق‌نظر وجود ندارد و هدف مطالعه حاضر تعیین این عوامل می‌باشد.
روش کار: در مطالعه مورد شاهدی گذشته‌نگر و در فاصله زمانی 78 ماهه، اطلاعات بالینی قبل و حین عمل بیماران با جراحی بای پس عروق کرونر که طی 30 روز بعد از عمل فوت کرده بودند (گروه مورد، 36 بیمار) با گروه شاهد به تعداد 144 نفر از بیمارانی که به دنبال جراحی فوت نکرده بودند، ثبت و آنالیز گردید.
یافته‌ها: میزان مرگ ومیر در طی این فاصله زمانی 29/1% بود. سن بالا، جنس مؤنث، درگیری هر سه رگ کرونری، بیماری انسدادی مزمن ریوی، درگیری شریان اصلی کرونری چپ، نارسایی دریچه میترال، جراحی اورژانسی، شرایط بحرانی قبل از عمل، سطح هموگلوبین پایین، شمارش گلبول سفید خون بالا، آرتریوپاتی خارج قلبی، میانگین زمان کلامپ آئورتی بالا، هیپرتانسیون پولمونری، زمان بای پس قلبی ریوی بالا، استفاده از بالون پمپ داخل آئورتی، استفاده از اینوتروپ و استفاده از ضربان‌ساز قلبی ارتباط معنی‌داری با مرگ و میر داشتند.
نتیجه‌گیری: جراحی اورژانس در شرایط بحرانی قبل از عمل، به‌ویژه در زنان مسن با کوموربیدیتی‌های متعدد، مرگ و میر بالایی دارد. ارزیابی قبل از عمل و اصلاح عواملی مانند کم خونی، کنترل عوامل التهابی و مشکلات ریوی و کم کردن طول مدت جراحی جهت کاهش مرگ و میر بعد از جراحی کمک‌کننده خواهد بود.
 
 
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نوع مطالعه: پژوهشي | موضوع مقاله: قلب و عروق

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