Glenn术后延迟拔管的危险因素分析  

Analysis of risk factors for prolonged duration of mechanical ventilation after Glenn operation

作　　者：张汀洲[1] 冯昱[1] 贺彦[1] ZHANG Tingzhou;FENG Yu;HE Yan(Department of Pediatric Heart Center,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart,Lung and Blood Vessel Diseases,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所小儿心脏中心,100029

出　　处：《心肺血管病杂志》2022年第3期279-283,共5页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:分析Glenn术后延迟拔管的危险因素。方法:回顾2015年1月到2019年12月,收治行Glenn手术患儿163例临床资料,以有创通气时间24h作为节点,分为延迟拔管组41例、非延迟拔管组122例。结果:共纳入163例,单因素分析发现体质量、年龄、手术时间、术后24h内最大VIS、术后氧饱和度、术后上腔静脉压力、经历体外循环与延迟拔管的发生显著相关。多因素Logistic回归分析发现术后24h内最大VIS增加、术后氧饱和度降低及术后上腔静脉压力增高为Glenn术后延迟拔管的危险因素。结论:行Glenn手术的患儿发生延迟拔管受多种因素影响,了解危险因素有助于进一步优化术后治疗方案。Objective:To analyze the risk factors of prolonged duration of mechanical ventilation after Glenn surgery.Methods:Review the clinical data of 163 children who underwent Glenn surgery from January 2015 to December 2019.Prolonged duration of mechanical ventilation was defined as the duration of mechanical ventilation of more than 24 hours postoperatively.They were divided into delayed extubation group(41 cases)and non-delayed extubation group(122 cases).Results:A total of 163 cases were included.Univariate analysis found that weight,age,operation time,maximum vasoactive-inotropic score(VIS)in the first 24 hours,postoperative oxygen saturation,postoperative superior vena cava pressure,whether to use cardiopulmonary bypass were significantly associated with occurrence of prolonged duration of mechanical ventilation.Further multivariate logistic regression analysis found that increased maximum vasoactive-inotropic score(VIS)in the first 24 hours,increased postoperative superior vena cava pressure and decreased postoperative oxygen saturation were independent risk factors for prolonged duration of mechanical ventilation.Conclusions:Prolonged duration of mechanical ventilation in children undergoing Glenn surgery was affected by many factors.Understanding the risk factors could help further optimize the postoperative treatment plan.

关 键 词：Glenn手术 延迟拔管 危险因素 

分 类 号：R54[医药卫生—心血管疾病]