先天性心脏病患儿CPB后低氧血症发生的危险因素分析

doi:10.3969/j.issn.1006-6233.2017.09.018

摘要
图/表
参考文献(15)
相关文章 (7)

全文: PDF (1355 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要 目的: 探究先天性先脏病患者CPB(体外循环)后低氧血症发生的危险因素。方法: 选取本院2016年1月至2017年1月期间接收的98例先天性心脏病患儿病例资料,所有患儿均行手术治疗,CPB后有45例出现低氧血症,其余53例未出现低氧血症,经单因素及Logistic多因素回归分析CPB后低氧血症危险因素。结果: 低氧血症组患儿术后2h、6h以及12h和24hPaO₂/FiO₂水平均显著低于非低氧血症组,组间差异存在统计学意义(P<0.05)。进行单因素分析可见,低氧血症组和非低氧血症组患儿的年龄、体重、术前存在右向左分流、术前肺动脉高压、术中机械通气模式差异存在统计学意义(P<0.01);经Logistic多因素回归分析发现,年龄小、肥胖以及术前合并右向左分流及肺动脉高压是诱发先天性心脏病CPB后低氧血症的高危因素。结论: 先天性心脏病患儿CPB后低氧血症的发生和患儿的低龄、肥胖以及术前合并右向左分流及肺动脉高压密切相关。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章

关键词 ：先天性心脏病, CPB, 低氧血症, 危险因素

Abstract：Objective: To investigate the risk factors of hypoxemia after CPB in congenital patients with congenital heart disease. Methods: A total of 98 children with congenital heart disease received from January 2016 to January 2017 were selected, all children underwent surgical treatment, CPB after 45 cases of hypoxemia, the remaining 53 cases did not appear hypoxemia, risk factors for hypoxemia after CPB were analyzed by single factor and Logistic multivariate regression. Results: The PaO₂/FiO₂ levels of 2h, 6h, 12h and 24h in children with hypoxemia were lower than those in non hypoxic group, and there was significant difference between the two groups (P <|0.05). Univariate analysis showed that there were significant differences in age, body weight, preoperative right-to-left shunt, preoperative pulmonary hypertension, and intraoperative ventilation patterns (P <0.01);Logistic multivariate regression analysis showed that low age, obesity, preoperative combined right to left shunt, pulmonary hypertension was congenital heart disease in children after CPB hypoxemia occurred in high risk factors. Conclusion: The incidence of hypoxemia in children with congenital heart disease is closely related to the low age, obesity and preoperative right - to - left shunt and pulmonary hypertension.

Key words： Congenital heart disease CPB Hypoxemia Risk factors

基金资助:四川省卫生厅课题,(编号:16PJ073)

引用本文:

周春龙, 张利兵, 郭浪涛, 徐晓燕, 付强. 先天性心脏病患儿CPB后低氧血症发生的危险因素分析[J]. 河北医学, 2017, 23(9): 1470-1473.
ZHOU Chunlong, ZHANG Libing, GUO Langtao, et al. Analysis of Risk Factors of Hypoxemia after CPB in Children with Congenital Heart Disease. 河北医学, 2017, 23(9): 1470-1473.

链接本文:

http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2017.09.018 或 http://www.hbyxzzs.cn/CN/Y2017/V23/I9/1470

[1] 许卫江,陈祖君,肖红艳,等.体外循环冠状动脉旁路移植术后低氧血症的危险因素分析[J].中国综合临床,2011,27(3):249~252.
[2] 沈亮,陆晨希,仲崇俊,等.非体外循环下冠状动脉旁路移植术后低氧血症的危险因素分析[J].解放军医学院学报,2014,35(1):49~51,91.
[3] El Guerrab A,Cayre A,Kwiatkowski F,et al.Quantification of hypoxia-related gene expression as a potential approach for clinical outcome prediction in breast cancer[J].PLoS One.2017,21;12(4):e0175960.
[4] 肖燕燕,姚勇,郑建勇,等.婴幼儿先天性心脏病体外循环术后急性肾损伤的相关临床危险因素[J].实用儿科临床杂志,2012,27(7):519~521.
[5] Hua K,Sheng JJ,Dong R.Short-term clinical outcomes and risk factors associated with in-hospital mortality in patients undergoing off-pump coronary artery bypass grafting[J].Zhonghua Yi Xue Za Zhi.2017;97(16):1218~1221.
[6] 王红,贾明,李呈龙,等.头罩持续气道内正压治疗体外循环心脏手术拔除气管插管后低氧血症初探[J].中国体外循环杂志,2014,12(2):92~95.
[7] 余艳.小儿先天性心脏病术后低氧血症的早期观察及护理[J].护理实践与研究,2012,9(9):72~73.
[8] 沈立,薛松,汪永义,等.冠状动脉旁路移植术后低氧血症危险因素研究[J].中国心血管病研究,2014,12(2):102~106.
[9] 周琦.心脏体外循环手术围手术期并发症的护理[J].护理实践与研究,2015,12(9):47~48.
[10] Sabzi F,Faraji R.Effect of body mass index on postoperative complications in beating coronary artery surgery[J].Ethiop Health Sci.2016;26(6):509~516.
[11] 黄悦,张马忠,宋艳艳,等.小儿先天性心脏病快通道手术后早拔管的体外循环影响因素分析[J].上海交通大学学报(医学版),2011,31(9):1320~1324.
[12] 孙广龙,曹向戎,张健群,等.非体外循环冠状动脉旁路移植术后低氧血症相关因素分析[J].心肺血管病杂志,2011,30(5):411~413.
[13] Takayama T,Akutsu N,Hiro T,et al.A case of giant saphenous vein graft aneurysm followed serially after coronary artery bypass surgery[J].Open Med(Wars).2016,11(1):155~157.
[14] 冯靖,季强,梅运清,等.冠状动脉旁路移植术后低氧血症的相关因素分析[J].同济大学学报(医学版),2012,33(5):53~56.
[15] Howard LS,Santhirapla V,Murphy K,et al.Cardiopulmonary exercise testing demonstrates maintenance of exercise capanity in patient with hpoxemiia and pilmonary arteriovenous malformations[J].Chest,2014,146(3):709~718.