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河北医学  2017, Vol. 23 Issue (9): 1470-1473    DOI: 10.3969/j.issn.1006-6233.2017.09.018
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先天性心脏病患儿CPB后低氧血症发生的危险因素分析
周春龙1, 张利兵1, 郭浪涛1, 徐晓燕1, 付强2
1.四川省成都市妇女儿童中心医院小儿外科, 四川 成都 610091
2.成都医学院第一附属医院心胸外科, 四川 成都 610000
Analysis of Risk Factors of Hypoxemia after CPB in Children with Congenital Heart Disease
ZHOU Chunlong, ZHANG Libing, GUO Langtao, et al
Chengdu Women and Children's Hospital, Sichuan Chengdu 610091, China
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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。
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关键词 先天性心脏病CPB低氧血症危险因素    
AbstractObjective: 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 wordsCongenital 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
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