术前血清白蛋白对法乐四联症患儿心内矫治术后早期预后的影响  

Impact of Preoperative Serum Albumin on Early Postoperative Prognosis in Children With Tetralogy of Fallot

作　　者：黄江姗 武勰 王红柏 晏馥霞 HUANG Jiangshan;WU Xie;WANG Hongbai;YAN Fuxia(Department of Anesthesiology,National Center for Cardiovascular Diseases and Fuwai Hospital,CAMS and PUMC,Beijing(100037),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、麻醉中心,北京市100037

出　　处：《中国循环杂志》2023年第3期343-348,共6页Chinese Circulation Journal

基　　金：国家自然科学基金(81870070)。

摘　　要：目的:探讨术前血清白蛋白(preoperative serum albumin,pre-ALB)对法乐四联症患儿心内矫治术后早期预后的影响。方法:选取2016年1月至2018年12月在中国医学科学院阜外医院接受法乐四联症心内矫治术的患儿692例。按照pre-ALB的P25水平将患儿分为低血清白蛋白(ALB)组(pre-ALB<42.2 g/L)和对照组(pre-ALB≥42.2 g/L),通过倾向性评分匹配方法比较两组患儿的早期预后。结果:经倾向性评分匹配后,低ALB组与对照组的患儿各166例。低ALB组与对照组相比较,患儿院内死亡率差异无统计学意义(1.20%vs.0%,P=0.156),但术后急性肾损伤的发生率更高(21.69%vs.9.04%,P=0.001),术后机械通气时间较长[23(11,44)h vs.17(10,27)h,P=0.022],重症监护病房停留时间[3(2,5)d vs.2(1,4)d,P=0.026]、住院时间[15(13,19)d vs.14(12,18)d,P=0.045]和住院总费用[80304(65226,94356)元vs.69397(60591,86184)元,P=0.001]明显增加,差异均有统计学意义。结论:pre-ALB影响法乐四联症患儿心内矫治术后恢复,低pre-ALB的法乐四联症患儿术后早期预后较差。Objectives:To investigate the impact of preoperative serum albumin(pre-ALB)on early postoperative prognosis in children with tetralogy of Fallot.Methods:A total of 692 pediatric patients,who underwent corrective operations for tetralogy of Fallot in Fuwai Hospital from January 2016 to December 2018,were included in this study.According to the P25 level of pre-ALB,the children were divided into low ALB group(pre-ALB<42.2 g/L)and the control group(pre-ALB≥42.2 g/L).Early postoperative prognoses were compared between the groups through propensity score matching method(PSM).Results:Post PSM,166 children were allocated in the low ALB group and 166 children in the control group.There was no significant difference in in-hospital death between groups(1.20%vs.0%,P=0.156).Incidence of acute kidney injury was significantly higher(21.69%vs.9.04%,P=0.001)and duration of mechanical ventilation was significantly longer(23[11,44]h vs.17[10,27]h,P=0.022)in the low ALB group than in the control group.The length of ICU stay(3[2,5]d vs.2[1,4]d,P=0.026),hospital stay(15[13,19]d vs.14[12,18]d,P=0.045)and the total hospitalization cost(80304[65226,94356]yuan vs.69397[60591,86184]yuan,P=0.001)were also significantly increased in the low ALB group than in the control group.Conclusions:Pre-ALB affects postoperative recovery of children with tetralogy of Fallot.Low pre-ALB is associated with poorer early postoperative prognosis in children with tetralogy of Fallot.

关 键 词：血清白蛋白 法乐四联症 预后 急性肾损伤 

分 类 号：R541.4[医药卫生—心血管疾病]