婴幼儿心脏术后血小板减少的影响因素和后果  

Thrombocytopenia following pediatric congenital heart surgery operations

作　　者：杨霄[1] 杨霞[1] 谢辉[1] 李玉杰[2] 温永金[2] 

机构地区：[1]郑州人民医院检验科,郑州450000 [2]郑州人民医院心脏大血管外科,郑州450000

出　　处：《医药论坛杂志》2017年第12期43-45,共3页Journal of Medical Forum

摘　　要：目的探索婴幼儿心脏术后血小板减少发生的影响因素和后果。方法选取2017年1月至2017年7月郑州人民医院收治的3岁以下的婴幼儿心脏手术128例,其中体外循环下手术94例,包括紫绀型先天性心脏病24例,同期行非体外循环下心脏手术34例,术后1周内反复复查血小板计数。结果体外循环下手术发生血小板减少(<100×10~9/L)31例,非体外循环下手术无发生。体外循环下手术24例紫绀型心脏病中13例发生,非紫绀型70例中18例发生,P=0.011。计量资料用四分位数表示,血小板减少组的年龄8(4~13)个月、体质量6.5(4.5~9)kg、主动脉阻断时间51(41~100)min、体外循环时间78(65~152)min、呼吸机辅助时间21(7~46)h、ICU滞留时间90(45~115)h与体外循环术后非血小板减少组的12(7~17)个月、9(8~11)kg、41(36~49)min、69(60~83)min、6(5~20)h、38(19~89)h相比,P均<0.05。结论体外循环、紫绀、年龄小、体质量轻、体外循环时间长和主动脉阻断时间长易于发生血小板减少,血小板减少患儿易出现呼吸机辅助时间和ICU滞留时间延长。Objective To analyze the influential factors of the occurrence of thrombocytopenia following pediatric congenital heart surgery and its outcomes. Methods Totally 128 infants aged below 3 years old were enrolled,who underwent cardiac surgeries in which there were 94 extracorporeal circulation surgeries including 24 infants with cyanotic congenital heart diseases,and 34 non-extracorporeal circulation surgeries in the same period. Platelet counts were rechecked repeatedly for infants who showed thrombocytopenia（ 〈 100 × 109/L） within 1 week after surgeries until no thrombocytopenia（ ≥100 × 109/L） was identified or infants were discharged. Results Thrombocytopenia occurred in 31 infants undergoing extracorporeal circulation surgeries; and no thrombocytopenia was noted in infants undergoing non-extracorporeal circulation surgeries. In extracorporeal circulation surgeries,thrombocytopenia occurred in 13 of 24 infants with cyanotic heart diseases,and in 18 of 70 infants with non-cyanotic heart diseases（ P = 0. 011）. There were 2 cases of death in 31 cases of thrombocytopenia,and no death was observed in 63 cases of non-thrombocytopenia after extracorporeal circulation surgeries（ P = 0. 201）. Measurement data are expressed as median（ IQR）. After extracorporeal circulation surgeries,in infants with or without thrombocytopenia,there were the age of 8（ 4-13） months and 12（ 7-17） months,the body weight of 6. 5（ 4. 5-9） kg and 9（ 8-11） kg,the aortic clamping time of 51（ 41-100） minutes and 41（ 36-49） minutes,the extracorporeal circulation time of 78（ 65-152） minutes and 69（ 60-83） minutes,the mechanical ventilation time of 21（ 7-46） hours and 6（ 5-20） hours,and the staying time in ICU of 90（ 45-115）hours and 38（ 19-89） hours,respectively（ all P 〈 0. 05）. Conclusion Extracorporeal circulation,cyanosis,younger age,lighter body weight,and long time of extracorporeal circulation and aortic clamping easily cause thrombocytopenia,and which easily increa

关 键 词：血小板减少 婴幼儿 先天性心脏病 体外循环 

分 类 号：R725.4[医药卫生—儿科]