婴幼儿体外循环术后毛细血管渗漏的危险因素  

The risk factors of capillary leak syndrome after extracorporeal bypass in infants

作　　者：何小军[1] 舒强[1] 谈林华[1] 

机构地区：[1]浙江大学医学院附属儿童医院胸外科,杭州310003

出　　处：《中华急诊医学杂志》2008年第6期642-645,共4页Chinese Journal of Emergency Medicine

基　　金：国家自然科学基金（30671968）;浙江省科技厅项目（2006C23026）;省部共建项目（wkj2006-2-002）

摘　　要：目的探讨婴幼儿先天性心脏病（简称先心）患儿经历体外循环手术后发生毛细血管渗漏综合征（capillary leak syndrome，CLS）的相关危险因素，为预防和控制CLS的发生提供依据。方法回顾性研究浙江大学医学院附属儿童医院2003年6月至2007年7月38例行体外循环手术后发生CLS的婴幼儿先心患儿的临床资料，对照组为随机抽取同期150例行体外循环手术后未发生CLS的婴幼儿先心患儿，对可能引起CLS的因素采用二分类进行单因素和多因素非条件Logistic逐步回归分析，以确定与CLS发病相关的独立危险因素；并对两组患儿术后治疗转归进行总结。结果①Logistic回归分析显示发生CLS的独立危险因素按OR值排序分别是：体外循环时间≥120min（OR=10．353）、紫绀型心脏病（OR=6．912）、年龄≤1岁（OR=6．254）、体外循环温度≤25℃（OR=4．151）。②CLS组行腹膜透析10例，死亡4例；对照组无腹膜透析病例及死亡病例。结论体外循环时间、心脏病类型、年龄、体外循环温度是婴幼儿体外循环术后发生CLS的独立危险因素。Objective To detemtine risk factors and treatments of capillary leak syndrome （CLS） in infants with congenital heart disease（CHD）after extracorpereal bypass （CBP）. Method A retrospective study of 38 infants with CLS and another 150 cases without CLS of a random choice who underwent extracorporeal bypass from June 2003 to July 2007 was carried out. Several risk factors with statistical significance were screened out with univarite logistic regression analysis, and the independent rask factors of CLS were determined with multivariate stepwise logistic regression analysis, The outcome of CLS infants was compared with infants of control group. Results Logistic analysis showed the risk factors of CLS were the duration of CBP （ OR = 10. 353）, type of CHD （ OR = 6. 912）, age （OR = 6. 254） and temperatm＇e of CBP （OR = 4. 151 ）. Of the CLS infants cohort, 10 cases underwent peritoneal dialysis and 4 cases died. Conclusions The risk factors of CLS in infants after CBP are the length of time consumed during CBP, type of CHD, age and temperature of CBP.

关 键 词：婴幼儿 体外循环 毛细血管渗漏综合征 危险因素 

分 类 号：R726.5[医药卫生—儿科]