左冠状动脉起源于肺动脉术后早期预后影响因素分析  

Analysis of factors influencing the early prognosis of anomalous origin of the left coronary artery from the pulmonary artery after surgical treatment

作　　者：张汀洲[1] 贺彦[1] Zhang Tingzhou;He Yan(Department of Pediatric Heart Center,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China;不详)

机构地区：[1]首都医科大学附属北京安贞医院小儿心脏中心,北京100029

出　　处：《中国循证心血管医学杂志》2022年第8期983-986,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的 回顾研究左冠状动脉(左冠脉)起源于肺动脉矫治术后早期预后的影响因素。方法研究回顾北京安贞医院于2012年1月至2020年12月左冠脉起源于肺动脉(ALCAPA)51例患儿围术期的相关数据,观察生存组及死亡组的相关数据,统计早期预后的危险因素。结果 51例临床资料中死亡7例(13.7%),存活44例(86.3%);女患儿29例,男患儿22例,年龄2月~15岁;体重4~97 kg。死亡组的阻断时间(111.00±31.96)min比存活组(90.16±21.02)min显著增加。死亡组的术后并发症发生率85.7%(6/7)比存活组27.3%(12/44)显著增高。出院前LVEF较术后24h LVEF改善,术后24h LVEF较术前LVEF显著下降。术后并发症为ALCAPA术后早期预后的独立危险因素(OR=0.096,P=0.042,95%CI:0.01~0.915)。结论 术后并发症为ALCAPA术后早期预后的独立危险因素。术后及时应用体外膜肺氧合(ECMO)可提高生存率。术前LVEF不是ALCAPA术后早期预后的独立危险因素。Objective To study the factors influencing the early prognosis of anomalous origin of the left coronary artery from the pulmonary artery after surgical treatment. Methods The perioperative data of 51 children with ALCAPA in our hospital from January 2012 to December 2020 were reviewed, the relevant data of the survival group and the death group were observed, and the risk factors for early prognosis were analyzed. Results A total of 51 cases of clinical data were collected, of which 7 cases(13.7%) died, and 44 cases(86.3%) survived. There were 29 females and 22 males. The minimum age was two months, and the maximum age was 15 years old;The lightest weight was 4 kg, and the heaviest was 97 kg. The cross-clamp time in the death group(111.00 min±31.96 min) was significantly increased compared with that in the survival group(90.16 min±21.02 min). The postoperative complication rate of the death group was 85.7%(6/7), significantly higher than that of the survival group, 27.3%(12/44). LVEF before discharge was improved compared with 24 hours LVEF after the operation.Twenty-four hours of LVEF after the operation was decreased significantly compared with preoperative LVEF.Postoperative complications were independent risk factors for early postoperative prognosis of ALCAPA(OR=0.096,P=0.042, 95%CI: 0.010~0.915). Conclusion Postoperative complications are independent risk factors for the early postoperative prognosis of ALCAPA. The timely application of ECMO after surgery can improve survival.Preoperative LVEF is not an independent risk factor for early prognosis after surgery.

关 键 词：左冠状动脉起源于肺动脉 术后并发症 预后 

分 类 号：R543.3[医药卫生—心血管疾病]