中国小儿急救医学
中國小兒急救醫學
중국소인급구의학
CHINESE PEDIATRIC EMERGENCY MEDICINE
2012年
6期
590-592
,共3页
周智恩%孙小圣%熊霞霞%冯君%陈红英%何伦德%王道庄%邓硕曾
週智恩%孫小聖%熊霞霞%馮君%陳紅英%何倫德%王道莊%鄧碩曾
주지은%손소골%웅하하%풍군%진홍영%하륜덕%왕도장%산석증
心内直视手术%多脏器功能障碍综合征%危险因素%儿童
心內直視手術%多髒器功能障礙綜閤徵%危險因素%兒童
심내직시수술%다장기공능장애종합정%위험인소%인동
Cardiopulmonary bypass%Multiple organ dysfunction syndrome%Risk factors%Children
目的 分析小儿心内直视手术后多脏器功能障碍综合征(multiple organ dysfunction syndrome,MODS)的危险因素.方法 将2001年1月至2010年12月间完成的1899例先天性心脏病(先心病)手术患儿,按术后有无MODS分为两组,进行单因素分析和多因素Logistic回归分析.结果 术后发生MODS 35例,发生率为1.84％,病死率为51.43％.单因素分析显示:复杂先心病、围术期发生意外、体外循环时间、主动脉阻断时间、呼吸机辅助时间、术后感染与术后发生MODS有关.经多因素Logistic回归分析显示:复杂先心病、围术期发生意外、体外循环时间超过180 min、术后感染为小儿心内直视手术后MODS的危险因素.结论 对于存在MODS危险因素的患儿应给予更为细致的围手术期及术后的监测与预防.
目的 分析小兒心內直視手術後多髒器功能障礙綜閤徵(multiple organ dysfunction syndrome,MODS)的危險因素.方法 將2001年1月至2010年12月間完成的1899例先天性心髒病(先心病)手術患兒,按術後有無MODS分為兩組,進行單因素分析和多因素Logistic迴歸分析.結果 術後髮生MODS 35例,髮生率為1.84％,病死率為51.43％.單因素分析顯示:複雜先心病、圍術期髮生意外、體外循環時間、主動脈阻斷時間、呼吸機輔助時間、術後感染與術後髮生MODS有關.經多因素Logistic迴歸分析顯示:複雜先心病、圍術期髮生意外、體外循環時間超過180 min、術後感染為小兒心內直視手術後MODS的危險因素.結論 對于存在MODS危險因素的患兒應給予更為細緻的圍手術期及術後的鑑測與預防.
목적 분석소인심내직시수술후다장기공능장애종합정(multiple organ dysfunction syndrome,MODS)적위험인소.방법 장2001년1월지2010년12월간완성적1899례선천성심장병(선심병)수술환인,안술후유무MODS분위량조,진행단인소분석화다인소Logistic회귀분석.결과 술후발생MODS 35례,발생솔위1.84％,병사솔위51.43％.단인소분석현시:복잡선심병、위술기발생의외、체외순배시간、주동맥조단시간、호흡궤보조시간、술후감염여술후발생MODS유관.경다인소Logistic회귀분석현시:복잡선심병、위술기발생의외、체외순배시간초과180 min、술후감염위소인심내직시수술후MODS적위험인소.결론 대우존재MODS위험인소적환인응급여경위세치적위수술기급술후적감측여예방.
Objective To analyze the risk factors associated with multiple organ dysfunction syndrome (MODS) in children after cardiopulmonary bypass (CPB).Methods Between Jan 2001 and Dec 2010,1 899 patients undergoing open heart surgery were reviewed retrospectively according to the presence or absence of MODS.Univariate and multivariate logistic regression analysis were used to identify the risk factors.Results Thirty-five patients (1.84％) developed MODS,the mortality for MODS was 51.43％ (18/35).Univariate risk factors included complex congenital heart disease,perioperative unexpected events,CPB time,aortic cross-clamping time,mechanical ventilation time,and postoperative spsis.Multivariate logistic regression analysis identified that complex congenital heart disease,perioperative unexpected events,CPB time ＞ 180 min,postoperative spsis were risk factors.Conclusion The results suggest that the patients with MODS risk factors described above need more careful peri and post operative surveillance and preventive management.
