تعیین ارتباط بین امتیاز STS risk score ومیزان بروز دلیریوم بعد عمل در ICU در جراحی بای پس عروق کرونر به روش off pump

نوع مقاله : مقاله پژوهشی

نویسندگان

1 دانشیار بیهوشی ، دانشگاه علوم پزشکی مشهد ، مشهد ، ایران.

2 دانشگاه علوم پزشکی مشهد ، مشهد ، ایران.

3 گروه جراحی قلب ، دانشگاه علوم پزشکی مشهد ، مشهد ، ایران.

4 دانشجوی بیهوشی ، دانشگاه علوم پزشکی مشهد ، مشهد ، ایران.

چکیده

هدف: در مطالعه حاضر، با هدف بررسی ارتباط بین امتیاز STS risk score1 ومیزان بروز دلیریوم بعد عمل در ICU در جراحی بای پس عروق کرونر به روش off pump انجام شد.
روش اجرا و مواد مورد استفاده:
 150 بیمار بین سنین 18 تا 75 سال که تحت جراحی الکتیو off-pump CABG2 قرار گرفتند ، حین عمل از نظر STS risk score بررسی شدند ، پروتکل بیهوشی یکسان بود. دلیریوم در بیمار با چک لیست CAM ICU توسط پرستار آموزش دیده بعد ازاکستوباسیون در ICUبررسی شد.
یافته ها:
فراوانی زن و مرد به ترتیب 57 و 93 نفر بود . از نظر STS بین دو گروه دارا و فاقد دلیریوم تفاوت معناداری مشاهده نشد. در بررسی تفاوتهای بین داده های کمی بین دو گروه  نشان داد که تعداد گرافت ها و مدت زمان بستری در بیمارستان در گروهی که دلیریوم داشتن بطور معناداری بیشتر بوده است ، ولی بقیه شاخص ها تفاوت معناداری بین دو گروه مشاهده نشد. در بررسی داده ها نشان دادند که بین سن با وزن و STS   همبستگی  معناداری وجود دارد . وزن و  قد و شاخص توده بدنی و  قد بیماران با   STS ، همچنین تعداد پکسل دریافت شده حین عمل با STS ،  ptl با EF4 قبل عمل و مدت زمان عمل  همبستگی معناداری داشت.
نتیجه گیری:
در این مطالعه 4 نفر معادل 7/2 دچار دلیریوم شدند و وجود یا عدم وجود دلیریوم با STS اسکور تفاوت معناداری نشان نداده است.

کلیدواژه‌ها


عنوان مقاله [English]

The relationship between STS risk score and post-operative delerium in ICU in of pump coronary artery bypass graft surgery

نویسندگان [English]

  • Mahdi Fathi 1
  • Shahram Amini 1
  • Ghasem Soltani 1
  • Zahra Abbasi 2
  • Mohamad Abbasi teshnizi 3
  • Nahid Zirak 1
  • Narges Payab 4
1 1. Associate Professor of Anesthesiology, Mashhad University of Medical Sciences, Mashhad ,Iran.
2 Mashhad University of Medical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran.
3 Department of Cardiac Surgery, Mashhad University of Medical Sciences, Mashhad, Iran.
4 Student of Anesthesiology, Mashhad University of Medical Sciences, Mashhad, Iran.
چکیده [English]

Objective: Despite the improvement in postoperative outcomes, delirium is a common neurological complication after cardiac surgery. Therefore, the present study was conducted to investigate the relationship between STS risk score and postoperative delirium in ICU in coronary artery bypass graft surgery.
Methods & Materials: 150 patients between the ages of 18 and 75 who underwent elective off-pump CABG surgery were evaluated for STS risk score during the operation, the anesthesia protocol was the same, the patient's blood pressure was kept in the optimal range (map: 60-80). Delirium in the patient was assessed with a CAM ICU checklist by a trained nurse after extubation. After the operation, the care protocol was the same in the ICU and in the ICU after extubation, the rate of delirium was assessed by the trained nurse.
Results: Frequency male and female was 57 and 93 respectively.  STS, was no significant difference between the two groups .The number of grafts and the length of hospital stay  in the group  was significantly . No significant differences were observed between the two groups.There was a significant correlation between age and weight and STS  . Weight,  height  and body mass index had a significant correlation with STS. The number of pixels received during operation with STS has a significant  correlation. The number of platelets received during operation with EF before surgery and  duration of operation had a significant negative and positive correlation, respectively.
Conclusion:The presence or absence of Delirium did not show a significant difference with STS score. The presence or absence of Delirium did not show a significant difference with STS score.

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