婴儿期法洛四联症根治术后快速康复治疗  

Fast track surgery in the infants with tetralogy of fallot following surgical repair

作　　者：曾敏[1] 魏嵬[1] 郑林[1] 李守军[2] 闫军[2] 李霞[1] 鲁中原[1] 王旭[1] ZENG Min;WEI Wei;ZHENG Lin;LI Shou-jun;YAN Jun;LI Xia;LU Zhong-yuan;WANG Xu(Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 100037, Beijing, China)

机构地区：[1]中国医学科学院北京协和医学院,国家心血管病中心,阜外医院小儿心脏中心PICU,北京市100037 [2]中国医学科学院北京协和医学院,国家心血管病中心,阜外医院小儿心脏中心心脏外科,北京市1000372

出　　处：《中国分子心脏病学杂志》2019年第3期2918-2920,共3页Molecular Cardiology of China

基　　金：国家重点研发计划资助(2017YFC1308100)

摘　　要：目的探讨婴儿期法洛四联症(tetralogy of Fallot,TOF)根治术后患儿快速康复(fast track,FT)的可行性及相关风险因素。方法回顾性分析2017年1月至2017年12月我院年龄小于1岁TOF根治术病例156例。FT的定义为患者从手术室回PICU后24小时内撤离呼吸机。按照此定义,将患者分成FT组与非FT组。结果总体达到FT治疗比例为71.8%。FT组机械通气时间、ICU住院时间比非FT组明显降低(P<0.05)。二元logestic回归分析发现右室压/左室压(RVP/LVP)大于60%、高LAP是FT治疗的独立危险因素。结论 FT对于大多数婴儿期TOF根治术后的患儿是可行的。RVP/LVP比值、LAP是影响FT治疗的风险因素。Objective To explore the feasibility of fast track(FT) treatment and the risk factors in the infants following tetralogy of Fallot (TOF) repair. Methods 156 cases of TOF who were under 1 year old in our hospital from January 2017 to December 2017 were retrospectively analyzed. We defined a patient who was extubated within 24 hours after surgery and ICU length of stay less than 72 hours as fast track treatment. According to the definition, patients were divided into FT group and non-FT group. Results 71.8% of the patients was successful achieved FT treatment. The mechanical ventilation time and ICU length of stay were decreased in FT group (P<0.05). Binary logistic regression analysis showed that left atrial pressure (LAP) and right ventricular pressure/left ventricular pressure ratio (RVP/LVP) were independent risk factors for FT treatment. Conclusion Fast track treatment is feasible for most infants after TOF repair. RVP/LVP pressure and LAP may be risk factors related to FT treatment for these patients.

关 键 词：先天性心脏病 婴儿 法洛四联症 快速康复 

分 类 号：R726.5[医药卫生—儿科]