6月龄以下婴儿室间隔缺损修补术后早期气管插管拔管的影响因素分析  

Influencing factors of early tracheal extubation after operation of ventricular septal defect in infants aged under 6 months

作　　者：施经添 何伦德 金凌晖 黄惠毅 傅明鸿 Shi Jingtian;He Lunde;Jin Linghui;Huang Huiyi;Fu Minghong(Department of Pediatric Cardiac Surgery,Affiliated Quanzhou Children's Hospital,Fujian Medical University,Fujian 362000,China)

机构地区：[1]福建医科大学教学医院泉州市儿童医院小儿心外科,福建省泉州市362000

出　　处：《临床小儿外科杂志》2017年第4期386-390,415,共6页Journal of Clinical Pediatric Surgery

摘　　要：目的探讨6月龄以下婴儿室间隔缺损修补术后早期气管插管拔管的影响因素。方法对本院近3年来收治的70例6月龄以下婴儿室间隔缺损修补术后病例资料进行回顾性分析,将全部病例按气管插管拔管时间分为早期拔管组(<12 h)和非早期拔管组(≥12 h),比较两组在年龄、体重、CPB时间、主动脉阻断时间、室间隔缺损大小、术前是否合并肺部感染、肺动脉高压或气管狭窄等方面的差异,将可能的危险因素纳入多因素非条件Logistical回归模型,筛选出影响因素。结果 6月龄以下患儿共70例,早期气管插管拔管51(72.86%)例。早期拔管组患儿平均体重高于非早期拔管组患儿,分别为(5.58±1.22)kg和(4.76±1.02)kg,差异有统计学意义(t=2.606,P=0.011);早期拔管组患儿主动脉阻断时间和CPB时间分别为(30.75±11.33)min和(57.55±12.17)min,非早期拔管组患儿分别为(48.47±22.04)min和(82.53±25.57)min,差异有统计学意义(P<0.05)。早期拔管组患儿室间隔缺损明显小于非早期拔管组患儿[(0.81±0.24 cm)vs(1.07±0.25 cm)],差异有统计学意义(t=-3.892,P<0.001)。多因素Logistic回归分析结果显示体重、主动脉阻断时间、室间隔缺损大小和CPB时间是影响婴儿室间隔缺损术后早期气管插管拔管的因素。结论对于心内畸形简单但术前病情严重的低月龄低体重先天性心脏病婴儿,术后早期拔除气管插管是安全可行的。体重、主动脉阻断时间、室间隔缺损大小、CPB时间是影响术后早期气管插管拔管的主要因素。ObjectiveTo analyze the influencing factors of early tracheal extubation after operation of ventricular septal defect(VSD)in infants aged under6months MethodsIn recent3years,operations were performed for70VSD infants aged under6months Based upon timing of tracheal extubation,they were divided into two groups Body weight,age,cardiopulmonary bypass time,aortic cross clamping time,diameter size of ventricular septal defect,presence of lung infection,pulmonary hypertension and tracheal stenosis were collected for two groups and entered into computer using SPSS by two research assistants Univariate and multivariate logistic regression analyses were used for identifying the possible risk factors and analyzing the influencing factors of early tracheal extubation after operation of VSD ResultsAmong them,51cases had early extubation Multivariate analysis revealed that body weight,aortic cross clamping time,cardiopulmonary bypass time and diameter size of ventricular septal defect were significantly associated with early tracheal extubation ConclusionFor low weight infants with congenital heart disease,early tracheal extubation is both safe and feasible And body weight,aortic cross clamping time,cardiopulmonary bypass time and diameter size of ventricular septal defect are important influencing factors of early tracheal extubation after operation

关 键 词：婴儿 室间隔缺损 气管拔管 

分 类 号：R726.5[医药卫生—儿科]