摘要
目的探讨神经外科颅脑手术及脊柱手术术后早期新发房颤的发生规律及危险因素,对高危人群提供预见性护理提供依据。方法采用方便抽样法选取2019年3—6月于北京某三甲医院行神经外科颅脑手术及脊柱手术的患者107例。收集患者术后12 h心电图、一般资料和临床资料。分析房颤发生率及发生特征、住院时长及并发症发生率。采用Logistic回归模型分析危险因素。结果共纳入107例患者,术后发生早期新发房颤发生率为16.80%(18/107),持续性房颤发生率为1.87%(2/107)。术后新发房颤平均首发时间为术后261.00(87.00,419.00)min;术后4 h内房颤发生率最高(50.00%),之后呈现递减趋势。平均每次房颤的持续时间为3.00(1.50,8.30)min;总持续时间为5.50(3.00,11.25)min。术前血磷高、术前淋巴细胞百分比高、病灶位于脑干及岛叶以及术后空腹血糖较低是神经外科术后新发房颤的独立危险因素(P<0.05)。结论神经外科颅脑手术及脊柱手术术后新发房颤大多发生于术后8h内,对于患者术前血磷较高、术前淋巴细胞百分比较高、病灶位于脑干及岛叶以及术后空腹血糖较低应尤其关注其术后心律变化情况。
Objective To explore the occurrence regularity and risk factors of new-onset atrial fibrillation in early stage after brain and spinal surgery of Neurosurgery Department so as to provide a basis for carrying out predictive nursing for high-risk population.Methods From March to June 2019,we selected 107 patients with brain or spinal surgery of Neurosurgery Department at a ClassⅢGrade A hospital in Beijing by convenience sampling.Data were collected including electrocardiogram of patients 12 hours after surgery,general information and clinical data.We analyzed the incidence and characteristics of atrial fibrillation,hospital stay as well as incidences of complications.Logistic regression model was used to analyze the risk factors.Results A total of 107 patients were included.The incidences of new-onset atrial fibrillation in early stage after surgery and persistent atrial fibrillation were 16.80%(18/107)and 1.87%(2/107)respectively.The average onset time of new-onset atrial fibrillation after surgery was 261.00(87.00,419.00)min after surgery.The incidence(50.00%)of atrial fibrillation within 4 h after surgery was the highest,and decreased progressively after that.The average duration of atrial fibrillation every time was 3.00(1.50,8.30)min,and the total duration was 5.50(3.00,11.25)min.The risk factors of new-onset atrial fibrillation after surgery of Neurosurgery Department included the high levels of blood phosphate and lymphocyte percentage before surgery,lesion located in brainstem or insular lobe as well as a low level of fasting blood glucose after surgery(P<0.05).Conclusions New-onset atrial fibrillation after brain and spinal surgery of Neurosurgery Department mostly occurred within 8h after surgery.Pay attention to heart rhythm after surgery of patients with high levels of blood phosphate and lymphocyte percentage before surgery,lesion located in brainstem or insular lobe as well as a low level of fasting blood glucose after surgery.
作者
贾佳兴
秦港
刘溢思
吴芳琴
Jia Jiaxing;Qin Gang;Liu Yisi;Wu Fangqin(2015 Undergraduate Nursing,School of nursing,Capital Medical University,Beijing 100069,China;School of Nursing,Capital Medical University,Beijing 100069,China)
出处
《中华现代护理杂志》
2019年第36期4747-4753,共7页
Chinese Journal of Modern Nursing
关键词
神经外科
颅脑手术
脊柱手术
术后房颤
Neurosurgery
Brain surgery
Spinal surgery
Postoperative atrial fibrillation
