儿童先天性心脏病围术期死亡相关危险因素分析-麻醉学专业论文.docxVIP

英汉缩略语名词对照 英文缩写 英文全称 中文全称 RACHS-1 Risk Adjustment for Congenital Heart Surgery 1 先天性心脏病手术风险校 正评分 ASA American Society Of Anesthesiologists 美国麻醉医师协会 CPB cardiopulmonary bypass 体外循环 ACC aortic cross clamp 主动脉阻断 EACTS the European Association for Cardiothoracic Surgery 欧洲心胸外科学会 STS The Society of Thoracic Surgeons 胸外科医师学会 1 儿童先天性心脏病围术期死亡相关危险因素分析 摘 要 目的：研究分析体外循环下行先天性心脏病手术的患儿围术期死 亡的相关危险因素。 方法：对 2012 年 10 月至 2014 年 9 月年龄小于 7 岁的行先天性心 脏病手术的 973 例患儿相关临床资料做回顾性分析，分析资料主要包 括性别、年龄、体重、体外循环时间、RACHS-1 评分、术前合并疾病、 围术期机体代谢内环境等情况。 结果：973 例患儿中，926 例（95.17%）成功实施手术并存活出 院，47 例患儿在围术期发生死亡，死亡率为 4.83%。Logistic 回归分 析提示死亡的独立危险因素为体外循环时间＞120 分钟、ASA 分级、 RACHS-1 评分、术前肌酐/尿素氮异常。 结论：体外循环时间＞120 分钟、ASA 分级、RACHS-1 评分、术 前肌酐/尿素氮异常是引起儿童先天性心脏病围术期死亡的危险因素。 关键词：先天性心脏病 围术期 死亡 危险因素 2 ANALYSIS OF PERIOPERATIVE DEATH RELATED RISK FACTORS IN CHILDREN UNDERGOING CONGENITAL HEART DISEASE SURGERY ABSTRACT Purpose: To investigate risk factors of perioperative mortality associated with congenital heart disease surgery in children with cardiopulmonary bypass（CPB）. Methods: We retrospectively reviewed relevant clinical findings of 973 pediatric patients aged less than 7 years from October 2012 to September 2014.The clinical findings included gender、age、weight、CPB time、RACHS-1 score、complications before operation、perioperative metabolism of internal environment and so on. Results: Among the 973 children,926 of them had a successful operation and discharged alive,others were dead perioperation.Logistic regression was used to prompt CPB time＞120min、ASA grade、RACHS-1 score and abnormal blood Creatinine/urea nitrogen preoperation were the independent risk factors of death. Conclusion: CPB time＞120min、ASA grade、RACHS-1 score and abnormal blood Creatinine/urea nitrogen preoperation were the risk factors 3 of perioperative mortality associated with congenital heart disease surgery in children. Keywords:congenital heart disease, perioperative, death, risk factors 4 儿童先天性心脏病围术期死亡相关危险因素分析 前 言 先天性心脏病（