术前白蛋白水平与婴儿心脏术后低氧血症的相关性研究  

Study on correlation between preoperative albumin levels and postoperative hypoxemia in infants undergoing cardiac surgery

作　　者：王昭君[1] 刘琦[1] 鲍荣幸 周慧君 黄晓琴 Wang Zhaojun;Liu Qi;Bao Rongxing;Zhou Huijun;Huang Xiaoqin(The Second Department of Cardiac Surgical Intensive Care Unit,Guangdong Provincial People's Hospital(Guangdong Academy of Medical Sciences),Southern Medical University,Guangdong Cardiovascular Institute,Guangzhou,Guangdong 510080,China)

机构地区：[1]南方医科大学附属广东省人民医院(广东省医学科学院)广东省心血管病研究所心外科重症监护二科,广东广州510080

出　　处：《齐齐哈尔医学院学报》2024年第24期2339-2344,共6页Journal of Qiqihar Medical University

基　　金：广东省医学科学技术研究基金项目(A2023017)。

摘　　要：目的探讨术前白蛋白水平与婴儿心脏术后低氧血症的相关性。方法回顾性分析2019年1—4月在广东省人民医院进行体外循环下行心脏外科手术婴儿的临床资料。以术前白蛋白进行三等分分组,通过单因素和多因素logistic回归模型结合限制性立方样条模型分析术前白蛋白水平与婴儿心脏术后低氧血症的相关性。结果研究共纳入204例婴儿,有30例(14.7%)婴儿发生术后低氧血症,在校正多种因素的影响后,RCS分析提示术前白蛋白水平与术后低氧血症的发生呈现线性关系(非线性检验P=0.530)。多因素Logistic回归分析提示,术前白蛋白每增加5 g/L,术后发生低氧血症的风险减少58%(OR=0.42,P=0.007)。以低值组婴儿为参照,术后发生低氧血症的风险,中值组婴儿减少44%(OR=0.56,P=0.259)、高值组减少78%(OR=0.22,P=0.027)。结论低氧血症是婴儿心脏术后常见并发症,术前白蛋白水平越高,术后发生低氧血症的风险越低。Objective To explore the correlation between preoperative albumin levels and postoperative hypoxemia in infants undergoing cardiac surgery.Methods A retrospective analysis was conducted on the clinical data of infants who underwent cardiac surgery with cardiopulmonary bypass at Guangdong Provincial People's Hospital from January to April 2019.Infants were divided into three groups based on preoperative albumin levels.Univariate and multivariate logistic regression models combined with restricted cubic spline(RCS)models were used to analyze the correlation between preoperative albumin levels and postoperative hypoxemia in infants.Results A total of 204 infants were included in the study,with 30(14.7%)developing postoperative hypoxemia.After adjusting for various factors,RCS analysis indicated a linear relationship between preoperative albumin levels and the occurrence of postoperative hypoxemia(nonlinearity test P=0.530).Multivariate logistic regression analysis suggested that for every 5g/L increase in preoperative albumin,the risk of postoperative hypoxemia decreased by 58%(OR=0.42,P=0.007).Compared to the low-value group,the risk of postoperative hypoxemia decreased by 44%in the medium-value group(OR=0.56,P=0.259)and by 78%in the high-value group(OR=0.22,P=0.027).Conclusions Hypoxemia is a common complication following cardiac surgery in infants.The higher the preoperative albumin level,the lower the risk of postoperative hypoxemia.

关 键 词：低氧血症 白蛋白 心脏手术 婴儿 

分 类 号：R726.5[医药卫生—儿科]