临床儿科杂志
臨床兒科雜誌
림상인과잡지
2014年
9期
872-875
,共4页
先天性食管闭锁%先天性心脏病%病死率%危险因素%呼吸衰竭%心力衰竭
先天性食管閉鎖%先天性心髒病%病死率%危險因素%呼吸衰竭%心力衰竭
선천성식관폐쇄%선천성심장병%병사솔%위험인소%호흡쇠갈%심력쇠갈
congenital esophageal atresia%congenital heart disease%mortality%risk factor%respiratory failure%heart failure
目的：探讨先天性食管闭锁(CEA)合并简单先天性心脏病(CHD)新生儿预后不良的危险因素。方法回顾性分析1998年-2013年收治并手术的CEA合并简单CHD患儿的临床资料，包括一般情况、实验室检查、术后并发症等，并比较存活和死亡患儿的临床资料。结果75例患儿纳入最终研究，存活67例，死亡8例，病死率10.67%。死亡及存活患儿的出生胎龄，出生体质量，入院日龄，手术日龄，手术持续时间，手术前、手术当天、痊愈出院/死亡前最近的一次血常规、肝肾功能、电解质、血气分析的差异均无统计学意义(P均>0.05)；死亡患儿的呼吸衰竭和心力衰竭的发生比例均高于存活患儿，差异有统计学意义(75%、9.0%，P=0.000；50%、1.5%，P=0.000)。结论 CEA合并简单CDH患儿死亡可能与并发呼吸衰竭和心力衰竭有关。
目的：探討先天性食管閉鎖(CEA)閤併簡單先天性心髒病(CHD)新生兒預後不良的危險因素。方法迴顧性分析1998年-2013年收治併手術的CEA閤併簡單CHD患兒的臨床資料，包括一般情況、實驗室檢查、術後併髮癥等，併比較存活和死亡患兒的臨床資料。結果75例患兒納入最終研究，存活67例，死亡8例，病死率10.67%。死亡及存活患兒的齣生胎齡，齣生體質量，入院日齡，手術日齡，手術持續時間，手術前、手術噹天、痊愈齣院/死亡前最近的一次血常規、肝腎功能、電解質、血氣分析的差異均無統計學意義(P均>0.05)；死亡患兒的呼吸衰竭和心力衰竭的髮生比例均高于存活患兒，差異有統計學意義(75%、9.0%，P=0.000；50%、1.5%，P=0.000)。結論 CEA閤併簡單CDH患兒死亡可能與併髮呼吸衰竭和心力衰竭有關。
목적：탐토선천성식관폐쇄(CEA)합병간단선천성심장병(CHD)신생인예후불량적위험인소。방법회고성분석1998년-2013년수치병수술적CEA합병간단CHD환인적림상자료，포괄일반정황、실험실검사、술후병발증등，병비교존활화사망환인적림상자료。결과75례환인납입최종연구，존활67례，사망8례，병사솔10.67%。사망급존활환인적출생태령，출생체질량，입원일령，수술일령，수술지속시간，수술전、수술당천、전유출원/사망전최근적일차혈상규、간신공능、전해질、혈기분석적차이균무통계학의의(P균>0.05)；사망환인적호흡쇠갈화심력쇠갈적발생비례균고우존활환인，차이유통계학의의(75%、9.0%，P=0.000；50%、1.5%，P=0.000)。결론 CEA합병간단CDH환인사망가능여병발호흡쇠갈화심력쇠갈유관。
Objective: To investigate the risk factors for mortality in neonates with congenital esophageal atresia (CEA) and simple congenital heart disease (CHD) including atrial septal defect (ASD), ventricular septal defect (VSD) and patent ductus arteriosus (PDA). Methods The medical records of neonates with CEA and simple CHD who had surgery in Children’s Hospital of Chongqing Medical University from 1998 to 2013, were analyzed retrospectively. Factors including neonatal demographics, laboratory results and complications after surgery were compared between survivor and non-survivor groups. Results Seventy ifve cases were included in this study and the mortality was 10.67%(8/75). There was no signiifcant difference between non-survivor group (n=8) and survivor group (n=67) in factors such as gestational age, birth weight, age of admission, age at surgery, duration of surgery, full blood examination, serum electrolytes, blood gases, prevalence of septicemia, pneumothorax, and cold lesion syndrome. However, the prevalence of respiratory failure and heart failure in non-survivor group was higher than that in survivor group (75%vs. 9%, P=0.000;50%vs. 1.5%, P=0.000, respectively). Conclusions The poor outcome among neonates with CEA plus simple CHD might be associated with respiratory failure and heart failure.
