儿童体外循环心脏直视手术术中成分输血与术后-国家心血管病中心.pdfVIP

790 中国循环杂志 2015 年 8 月 第 30 卷 第 8 期（总第 206 期）Chinese Circulation Journal，August，2015，Vol. 30 No.8（Serial No.206） 临床研究 儿童体外循环心脏直视手术术中成分输血与术后预后的关系 王亮,陈贝贝,崔洁,刘立飞,徐红珍,唐文 摘要 目的：探讨体外循环（CPB）心脏直视手术患儿术中成分输血与术后预后的关系。 方法：回顾性分析 1 028 例接受 CPB 心脏直视手术患儿的临床资料，采用单因素分析及多元 Logistic 回归分析探 讨术中成分输血与术后院内死亡及并发症的关系。 结果：1 028 例患儿中，术后院内死亡 45 例（4.4%），发生低心排血量综合征 143 例（13.9%），急性肾功能衰竭 43 例（4.2%），肺衰竭 26 例（2.5%），感染 17 例（1.7%），神经系统并发症 28 例（2.7%）。多元 Logistic 回归分析显 示，术后院内死亡的独立危险因素为 CPB 时间、CPB 最低温度、术后 24 h 儿童死亡风险（PRISM- Ⅲ ）评分及术中红 细胞输注量 中位输注量（20.3 ml/kg），而术后并发症的独立危险因素为紫绀型先天性心脏病、CPB 时间、术后 24 h PRISM- Ⅲ评分、术后 6 h 纵膈引流量及术中红细胞输注量 20.3 ml/kg。 结论：儿童 CPB 心脏直视手术中输注大量红细胞增加术后院内死亡及并发症风险，减少术中红细胞输注可能会 改善先天性心脏病儿童的术后预后。 关键词 输血；并发症；体外循环；儿童 Relationship Between Blood Product Transfusion and Post-operative Prognosis in Children With Pediatric Open Heart Surgery by Cardiopulmonary Bypass WANG Liang, CHEN Bei-bei, CUI Jie, LIU Li-fei, XU Hong-zhen, TANG Wen. Department of Anesthesiology, Children’s Hospital of Chongqing Medical University, Chongqing (400014), China Corresponding Author: TANG Wen, Email: 1110@163.com Abstract Objective: To explore the relationship between intra-operative blood product transfusion and post-operative prognosis in children with pediatric open heart surgery by cardiopulmonary bypass (CPB). Methods: A total of 1028 consecutive pediatric patients received the open heart surgery by CPB in our hospital were retrospectively studied. Uni- and multivariate Logistic regression analysis were conducted to analyze the relationship between intra-operative blood product transfusion and post-operative in-hospital death and complication rates. Results: There were 45/1028 (4.4%) of patients died, 143 (13.9%) with low cardiac output syndrome, 43 (4.2%) received dialysis,