Abstract:

Objective　To investigate the thirst current situation and influencing factors after cardiopulmonary bypass. Methods　This study was a retrospective analysis. Clinical data of 65 patients with cardiopulmonary bypass admitted to Fuwai Central China Cardiovascular Hospital from March 2021 to April 2023 were collected, including 32 males and 33 females, aged (53.25±2.35) years, with a body mass index of (22.65±1.05) kg/m². The Thirst Distress Scale (TDS) was used to evaluate postoperative thirst in patients with cardiopulmonary bypass (CPB) after the removal of tracheal intubation (usually 2 ~ 3 days after surgery). The patients' gender (male/female), age (≥60 years old /<60 years old), education level (high school and below/college and above), underlying diseases (yes/no), duration of cardiopulmonary bypass (≤30 min/>30 min) disease type (coronary artery bypass surgery/tetralogy of Fallot/others), diuretic type (<2 types/≥2 types), serum sodium ion, mechanical ventilation time (≤3 h/>3 h), disease perception (good/poor), Self-Rating Anxiety Scale (SAS) score (≥50 points /<50 points), Self-Rating Depression Scale (SDS) score (≥53 points/<53 points), and attitude and behavior towards sodium restricted diet (good/poor) were collected and compared. Logistic regression analysis was used to examine the influencing factors of postoperative thirst in patients with cardiopulmonary bypass. t test was used for statistical analysis. Results　The TDS score of the 65 patients with cardiopulmonary bypass was (34.62±1.35) points. The TDS scores of the patients with age <60 years old, SAS score ≥50 points, SDS score ≥53 points, poor disease perception, and poor attitude and behavior towards sodium restricted diet were higher than those of the patients with age ≥60 years old, SAS score <50 points, SDS score <53 points, good disease perception, and good attitude and behavior towards sodium restricted diet [(35.71±1.25) points vs. (16.22±1.05) points, (34.88±1.75) points vs. (22.73±1.50) points, (35.56±1.67) points vs.(30.50±1.22) points, (37.50±1.85) points vs. (28.80±1.50) points, (37.67±1.88) points vs. (28.18±1.53) points], with statistically significant differences (t=68.253, 31.885, 14.653, 19.782, and 20.442, all P<0.001). Multiple linear regression analysis showed that age, SAS score, SDS score, disease perception, and attitude and behavior towards sodium restricted diet were all influencing factors of postoperative thirst in patients with cardiopulmonary bypass (all P<0.05). Conclusion　The patients with cardiopulmonary bypass have a higher TDS score after operation. Patients' age, SAS and SDS scores, disease perception, and attitude and behavior towards sodium restricted diet are all important factors affecting the TDS score in patients with cardiopulmonary bypass.

Key words:

Cardiopulmonary bypass, Thirst, Influencing factors, Psychological state, Disease perception

摘要：

目的　探讨心脏体外循环术后口渴现状及其影响因素。方法　本研究为回顾性分析。收集阜外华中心血管病医院2021年3月至2023年4月期间收治的65例心脏体外循环患者临床资料，其中男32例，女33例，年龄（53.25±2.35）岁，体重指数（22.65±1.05）kg/m²。于心脏体外循环手术患者清醒拔除气管插管后（一般为术后2～3 d），采用心力衰竭口渴困扰量表（TDS）评价患者术后口渴情况。收集并比较患者的基线资料，包括性别（男/女）、年龄（≥60岁/<60岁）、文化程度（高中及以下/大专及以上）、合并基础疾病（是/否）、体外循环时间（≤30 min/>30 min）、疾病种类（冠状动脉搭桥手术/法洛氏四联症/其他）、利尿剂种类（<2种/≥2种）、血清钠离子、机械通气时间（≤3 h/>3 h）、疾病感知（良好/差）、焦虑自评量表（SAS）评分（≥50分/<50分）、抑郁自评量表（SDS）评分（≥53分/<53分）、限钠饮食态度行为（良好/差）。采用logistic回归分析检验心脏体外循环患者术后发生口渴的影响因素。统计学方法采用t检验、F检验。结果　65例心脏体外循环患者术后TDS评分为（34.62±1.35）分。年龄<60岁、SAS评分≥50分、SDS评分≥53分、疾病感知差、限钠饮食态度行为差患者的术后TDS评分均高于年龄≥60岁、SAS评分<50分、SDS评分<53分、疾病感知良好、限钠饮食态度行为良好患者［（35.71±1.25）分比（16.22±1.05）分、（34.88±1.75）分比（22.73±1.50）分、（35.56±1.67）分比（30.50±1.22）分、（37.50±1.85）分比（28.80±1.50）分、（37.67±1.88）分比（28.18±1.53）分］，差异均有统计学意义（t=68.253、31.885、14.653、19.782、20.442，均P<0.001）。多元线性回归分析结果显示，年龄、SAS评分、SDS评分、疾病感知及限钠饮食态度行为均是心脏体外循环患者术后发生口渴的影响因素（均P<0.05）。结论　心脏体外循环患者术后TDS评分较高，患者的年龄、SAS和SDS评分、疾病感知、限钠饮食态度行为均是影响心脏体外循环患者术后TDS评分的重要因素。

关键词:

心脏体外循环, 口渴, 影响因素, 心理状态, 疾病感知