婴幼儿先心病术后早期撤机的术后相关因素  

Multivariable analysis of early withdrawal of ventilator after surgery in infants with congenital heart diseases

作　　者：林超[1] 林约瑟[1] 李运泉[1] 李轩狄[1] 巴宏军[1] 朱玲[1] 覃有振[1] 王慧深[1] LIN Chao;LIN Yuese;LI Yunquan;LI Xuandi;BA Hongjun;ZHU Lin;QIN Youzhen;WANG Huishen(Department of Pediatric Cardiology,the First Affiliated Hospital of Sun Yat-Sen University,Guangzhou 510080, China)

机构地区：[1]中山大学附属第一医院心血管儿科,广州510080

出　　处：《实用医学杂志》2019年第7期1084-1087,共4页The Journal of Practical Medicine

基　　金：广东省科技计划项目(编号:2012B031800298)

摘　　要：目的分析影响婴幼儿先心病(CHD)术后机械通气时间的术后相关因素。方法收集2014年1月1日至2017年1月1日在心脏重症监护室(CICU)监护的先心病术后婴幼儿临床资料,分析与术后早期撤机的关系。结果 (1)单因素分析提示先心病婴幼儿术后早期撤机率与术后拔管前NT-ProB-NP低、BUN低、Cr低、麻醉类药物使用时间短、无肺部并发症、无心律失常及液体出入量为负平衡有关(均P <0.05)。(2)非条件Logsitic回归分析提示,拔管前麻醉类药物使用时间是独立影响因素(OR=1.09,95%CI:1.05～1.13)。结论拔管前NT-ProBNP低、BUN低、Cr低、麻醉类药物使用时间短、无肺部并发症、无心律失常及液体出入量为负平衡均有利于婴幼儿先心病术后早期撤机,其拔管前麻醉类药物使用时间短是有利于早期撤机的独立影响因素。Objective To analyze the factors related to postoperative mechanical ventilation time in infants with congenital heart disease.Methods Infants with congenital heart disease who received treatment in the cardiac surgery intensive care unit of the First Affiliated Hospital of Sun Yat sen University from January 1,2014 to January 1,2017 were enrolled to analyze the relation between early withdrawal of ventilator and postopera tive related factors.Results(1)Univariate analysis showed that infants with congenital heart disease early postop erative rate of weaning and postoperative to extubation low NT ProBNP,low BUN,low Cr,short time of anesthesia drug,no lung complications,no arrhythmia and liquid intake negative balance(P<0.05).(2)Logistic regression analysis showed that anesthetics using time is an independent factors before extubation(OR=1.09,95%CI:1.05~1.13).Conclusions For infants with congenital heart disease,low NT ProBNP,low BUN,low Cr,short anes thetics using time,no condition of lung complications or no arrhythmia,and negative balance of fluid intake before extubation were protective factors for the early withdrawal of postoperative congenital heart disease.The short time of anesthesia drug is the independent influencing factors of early withdraw ventilator.

关 键 词：先心病术后 机械通气 早期撤机 术后影响因素 婴幼儿 

分 类 号：R726.5[医药卫生—儿科]