快通道麻醉对法洛四联症根治术患儿围术期康复的影响  

Effect of Fast Track Anesthesia Management on Perioperative Rehabilitation of Children with Tetralogy of Fallot

作　　者：贾爰[1] 罗启鹏 李轶楠 晏馥霞[1] JIA Yuan;LUO Qi-peng;LI Yi-nan;YAN Fu-xia(Center of Anesthesiology,National Center for Cardiovascular Diseases,Fuwai Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100037,China)

机构地区：[1]北京协和医学院,国家心血管病中心心,血管疾病国家重点实验室,中国医学科学院,阜外医院麻醉中心,北京市100037

出　　处：《中国分子心脏病学杂志》2020年第2期3281-3285,共5页Molecular Cardiology of China

基　　金：国家自然科学基金(81870070)。

摘　　要：目的通过回顾性分析法洛四联症患儿围术期临床资料,探讨快通道麻醉管理相较于传统麻醉管理方式是否具有优势。方法纳入2012年1月至2018年12月在我院行法洛四联症根治术的12岁以下患儿,选择所有快通道麻醉患儿(快通道组),通过倾向性评分方式匹配非快通道的传统麻醉患儿(常规组),比较两组患儿临床预后。结果快通道组共纳入226例患儿,常规组452例患儿,两组并发症无显著差异。与常规组相比,快通道组围术期输血(P=0.004)和血浆总量(P<0.001)明显减少,术后机械通气时间(P<0.001)、重症监护室停留时间(P<0.001)、术后住院时间(P<0.001)、住院总费用也明显减少(P<0.001)。结论快通道麻醉应用于法洛四联症患儿,不增加并发症发生率,明显减少血液制品用量、降低住院时间、节约医疗资源。Objective Through retrospective analysis of perioperative data of children with tetralogy of Fallot,compare the advantages of fast track anesthesia management with traditional anesthesia management.Methods From January 2012 to December 2018,children under 12 years old who underwent radical surgery for tetralogy of Fallot in our hospital were included.All children with fast track anesthesia(fast track group)were selected,matched and compared with non-fast track anesthesia(conventional group)through propensity score matching method.Results 226 children in fast track group and 452 children in conventional group were included for analysis.Compared with the conventional group,the total amount of blood(P=0.004)and plasma transfusion(P<0.001)was significantly reduced,the postoperative mechanical ventilation time(P<0.001),intensive care unit stay(P<0.001),postoperative hospital length of stay(P<0.001),and the total cost of hospitalization(P<0.001)were significantly reduced in the fast track anesthesia group.Conclusion The application of fast track anesthesia in children with tetralogy of Fallot is beneficial.It significantly reduces the amount of blood products transfusion,decreases the length of stay,and saves medical resources without increasing the incidence of morbidities.

关 键 词：法洛四联症 快通道麻醉 倾向性评分 

分 类 号：R726.1[医药卫生—儿科]