婴幼儿室间隔缺损修复术后早期心律失常原因分析  

Analysis on Risk Factors of Arrhythmia After Repair of Ventricular Septal Defect in Infants

作　　者：罗元芝[1] 胡南[1] 杨哲[1] 刘勇[1] 张晓桂[1] 朱通球[1] 

机构地区：[1]湖南省儿童医院特检科,湖南长沙410007

出　　处：《实用预防医学》2009年第4期1194-1196,共3页Practical Preventive Medicine

摘　　要：目的分析探讨婴幼儿先天性心脏病手术后早期心律失常的危险因素,以期降低其发生率。方法回顾性分析我院近3年的婴幼儿室间隔缺损手术的临床资料,比较分析早期心律失常发生的情况及原因。结果分析患儿348例,术后48h以内有97例出现各型心律失常(27.9%);手术前心胸比值≥0.6、合并肺部感染、合并肺动脉高压、术中主动脉阻断时间≥90min、术后血氧分压≤60mmHg、酸中毒、低心排者心律失常发生率更高;患儿年龄、VSD直径、手术方式等因素的不同,其心律失常发生率差异无统计学意义。结论心律失常是室间隔缺损修复手术后的常见早期并发症,心功能差、体外循环和阻断主动脉时间长、术后低心排是术后心律失常的重要原因。Objective To discuss the risk factors （VSD） in infants in order to reduce its incidence rate of early arrhythmia after surgical repair of ventricular septal defect Methods The clinical data of infants underwent surgical repair for VSD in recent three years were analyzed retrospectively. The occurrence rate and reasons of postoperative early arrhythmia were studied. Result Totally 348 infants were enrolled in this study, 97 of them （27.9 % ） had undergone various early arrhythmia during the first 48 hours postoperatively. Infants with higher cardiothoracic ratio （≥0.6）, complicating with pulmonary infection, accompanied with pulmonary hypertension, longer duration of aortic cross clamping （≥90 min）, lower blood oxygen pressure （≤60mmHg）, acidosis and low cardiac output syndrome had a higher occurrence rate of early arrhythmia.Age, diameters of VSD, and surgical technique did not impact the occurrence rate of early arrhythmia significantly. Conclusion Arrhythmia is a common postoperative complication in infants undergoing surgical repair of VSD. Cardiac dysfunction, longer duration of ischemia in operation and postoperative low cardiac output syndrome are risks factors for early arrhythmia.

关 键 词：心律失常 婴幼儿 室间隔缺损 

分 类 号：R725.4[医药卫生—儿科]