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《Chinese Journal of Cardiovascular Research》 2018-03
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Predictive value of early blood pressure fluctuations after coronary artery bypass grafting in the occurrence of malignant arrhythmias

LUO Zhu-jia;CHEN Yu-hong;Nursing Department,Nanjing Hospital Affiliated to Nanjing Medical University;  
Objective To investigate the blood pressure variability in early stage after coronary artery bypass grafting, and to evaluate the predictive value of blood pressure variability in the occurrence of malignant arrhythmia,so as to provide a practical basis for postoperative monitoring and disease evaluation. Methods A total of 120 patients undergoing coronary artery bypass grafting from March 2017 to August in cardiothoracic surgery of a third grade hospital were selected under the principle of convenient sampling, 120 patients were divided into two groups according to whether or not the malignant arrhythmia occurred after operation; general data, laboratory data and blood pressure values 24 hours after surgery were collected. The fluctuation of systolic blood pressure(SB) and diastolic blood pressure(DB) was assessed by mean real fluctuation(ARV). Results A total of 31 cases(25.83%)of malignant arrhythmia, including 21 cases(17.5%) of atrial fibrillation, 3 cases(2.5%) of atrial premature beat,3 cases(5%) of ventricular premature beat, 6 cases of ventricular fibrillation in 3 cases(2.5%), 3 cases(2.5%) of ventricular tachycardia, supraventricular tachycardia 2 cases(1.7%); malignant arrhythmia group SB_(AVE) and DB_(AVE);24 hours of total SB_(ARV) and DB_(ARV) values were greater than the non malignant arrhythmia group(P0.01). The results of Logistic regression analysis showed that SB_(ARV) and DB_(ARV) could predict the occurrence of malignant arrhythmia after operation 72 hours, and except the age(OR= 1.162) and mechanical ventilation time(OR=1. 174),SB_(ARV)and DB_(ARV) can also predict the occurrence of postoperative cardiac arrhythmias, the predictive power of SB_(ARV) was stronger(SB_(ARV)OR=2.92, DBAR,OR=1.941). Conclusion SB_(ARV) and DB_(ARV) value can predict the occurrence of malignant arrhythmia after coronary artery bypass grafting. Attention should also be paid to the blood pressure variability after operation, the postoperative blood pressure to maintain stability.
【CateGory Index】: R654.2
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