Clinical Observation Of Adrenal Insufficiency After Coronary Artery Bypass Grafting

Objective To evaluate the coronary artery bypass operation and after operation of relative probability of adrenal insufficiency, the possible predisposing factors and correlation, Thus in the treatment of the future, Thus In the treatment of the future, on susceptible adrenal insufficiency patients in preoperation period timely detection and treatment.Methods The98patients underwent coronary artery bypass operation preoperative detection of blood from vein blood cortical concentration, Compared with thehealthy control group. Patients in intensive care unit (ICU) after, all blood samples were taken for aldosterone, albumin, blood sugar, blood sodium detction.And scores of acute physiology and chronic health conditions (Acute Physiology and Chronic Health Evolution, APACHE-II); Enter the ICU the next morning for adrenocorticotropic hormone stimulation test (Adrenocorticotropic Hormone, ACTH), Before and after the experiment, Detection of serum aldosterone, cortisolconcentration in blood sampling value.Results1.The patient group and control group differences in age, gender, cortisol level, there were no significant differences in comparison.2. In the98patients, there were19cases of adrenal insufficiency, and corticotrophin response is good in78cases with sex, age, blood sodium, sugar, serum albumin concentration difference. Adrenal insufficiency group than in normal adrenal function group blood cortisol concentrations higher TO value, high APACHEII scores, longer Operation time. With the basal cortisol cone entrations were positively correlated with APACHEII score.3. The19cases of adrenal insufficiency patients with extracorporeal circulati on in11cases of anesthesia, anesthesia in8patients without cardiac arrest, the two group there was no statistics difference.4. Adrenal dysfunction group and no loss group under went ACTH stimulatio n before and after test, the concentration of aldosterone was no significa nt difference in comparison. 5. In98patients.24cases of hypotension. Among them, adrenal function in16patients with hypothyroidism group, adrenal function in normal group of8cases. Perioperative hypotension occurred in patients with adrenal insufficiency more likely.Conclusion APACHE II score and operation time in Coronary artery bypass graft patients influence relative adrenal insufficiency predisposing factors in the perioperative period. While Adrenal insufficiency incidence and whether the choice of extracorporeal circulation was no significant correlation..