心血管外科杂志(电子版)
心血管外科雜誌(電子版)
심혈관외과잡지(전자판)
Journal of Cardiovascular Surgery(Electronic Edition)
2014年
3期
134-137
,共4页
于浩%颜涛%童光%马涛%杨博%董文鹏%梅鲁刚%王显悦%陆华%张卫达
于浩%顏濤%童光%馬濤%楊博%董文鵬%梅魯剛%王顯悅%陸華%張衛達
우호%안도%동광%마도%양박%동문붕%매로강%왕현열%륙화%장위체
心脏缺损,先天性%体外循环%脓毒症%乳酸
心髒缺損,先天性%體外循環%膿毒癥%乳痠
심장결손,선천성%체외순배%농독증%유산
Heart defects,congenital%Extracorporeal circulation%Sepsis%Lactic acid
目的观察小儿复杂先天性心脏病体外循环术后血乳酸浓度与术后脓毒症发病率的临床相关性。方法回顾性分析我院2012年1月至2014年5月手术治疗复杂先天性心脏病小儿114例,男59例,女55例,年龄(6.17±3.19)个月,体重(6.54±1.61)kg,身高(63.79±8.48)cm,记录病例的体外循环时间、主动脉阻断时间、术后乳酸浓度、术后脓毒症发病情况。分为正常乳酸组(<2.25 mmol/L,n =44)、高乳酸组(≥2.25 mmol /L 并≤5 mmol /L,n =41)、乳酸酸中毒组(>5 mmol/L,n =29),比较分析各组之间各指标的差异。结果乳酸酸中毒组的体外循环时间、主动脉阻断时间、脓毒症发病率分别高于正常乳酸组和高乳酸组(均 P <0.05),而正常乳酸组和高乳酸组之间无统计学差异(P >0.05)。结论复杂先天性心脏病小儿在体外循环下行心脏畸形矫正术,术后乳酸浓度明显升高时并发脓毒症的风险增高。
目的觀察小兒複雜先天性心髒病體外循環術後血乳痠濃度與術後膿毒癥髮病率的臨床相關性。方法迴顧性分析我院2012年1月至2014年5月手術治療複雜先天性心髒病小兒114例,男59例,女55例,年齡(6.17±3.19)箇月,體重(6.54±1.61)kg,身高(63.79±8.48)cm,記錄病例的體外循環時間、主動脈阻斷時間、術後乳痠濃度、術後膿毒癥髮病情況。分為正常乳痠組(<2.25 mmol/L,n =44)、高乳痠組(≥2.25 mmol /L 併≤5 mmol /L,n =41)、乳痠痠中毒組(>5 mmol/L,n =29),比較分析各組之間各指標的差異。結果乳痠痠中毒組的體外循環時間、主動脈阻斷時間、膿毒癥髮病率分彆高于正常乳痠組和高乳痠組(均 P <0.05),而正常乳痠組和高乳痠組之間無統計學差異(P >0.05)。結論複雜先天性心髒病小兒在體外循環下行心髒畸形矯正術,術後乳痠濃度明顯升高時併髮膿毒癥的風險增高。
목적관찰소인복잡선천성심장병체외순배술후혈유산농도여술후농독증발병솔적림상상관성。방법회고성분석아원2012년1월지2014년5월수술치료복잡선천성심장병소인114례,남59례,녀55례,년령(6.17±3.19)개월,체중(6.54±1.61)kg,신고(63.79±8.48)cm,기록병례적체외순배시간、주동맥조단시간、술후유산농도、술후농독증발병정황。분위정상유산조(<2.25 mmol/L,n =44)、고유산조(≥2.25 mmol /L 병≤5 mmol /L,n =41)、유산산중독조(>5 mmol/L,n =29),비교분석각조지간각지표적차이。결과유산산중독조적체외순배시간、주동맥조단시간、농독증발병솔분별고우정상유산조화고유산조(균 P <0.05),이정상유산조화고유산조지간무통계학차이(P >0.05)。결론복잡선천성심장병소인재체외순배하행심장기형교정술,술후유산농도명현승고시병발농독증적풍험증고。
Objective To investigate the possible association of blood lactic acid concentration and occurrence of post-operative sepsis in complicated congenital heart disease patient treated with surgery under cardiopulmonary bypass (CPB).Methods From Jan.2012 to May.2014,114 pediatric patients (59 males,55 females)who were operated in our institute were enlisted in this retrospective study and divided into three following groups by blood lactic acid level:normal lactic acid level group ( <2.25 mmol/L),high lactic acid level group(≥2.25 mmol/L and≤5 mmol/L) and lactic acid intoxication group ( >5 mmol /L).The CPB time,cross-clamping time,post-operative lactic acid level and the occurrence of sepsis were recorded and compared among groups . Results Compared with normal lactic acid level group and high lactic acid level group ,CPB time,cross-clamping time and incidence of sepsis were higher in the lactic acid intoxication group ( P <0.05 ).No difference were observed between normal lactic acid level group and high lactic acid level group (P >0.05).Conclusions In pediatric patient with complicated congenital heart disease treated by surgery under CPB ,high post-operative lactic acid level is associated with increased risk of sepsis .