先天性心脏病患儿CPB后低氧血症发生的危险因素分析

目的:探究先天性先脏病患者CPB(体外循环)后低氧血症发生的危险因素.方法:选取本院2016年1月至2017年1月期间接收的98例先天性心脏病患儿病例资料,所有患儿均行手术治疗,CPB后有45例出现低氧血症,其余53例未出现低氧血症,经单因素及Logistic多因素回归分析CPB后低氧血症危险因素.结果:低氧血症组患儿术后2h、6h以及12h和24hPaO2/FiO2水平均显著低于非低氧血症组,组间差异存在统计学意义(P<0.05).进行单因素分析可见,低氧血症组和非低氧血症组患儿的年龄、体重、术前存在右向左分流、术前肺动脉高压、术中机械通气模式差异存在统计学意义(P<0.01);经Logistic多因素回归分析发现,年龄小、肥胖以及术前合并右向左分流及肺动脉高压是诱发先天性心脏病CPB后低氧血症的高危因素.结论:先天性心脏病患儿CPB后低氧血症的发生和患儿的低龄、肥胖以及术前合并右向左分流及肺动脉高压密切相关.

Analysis of Risk Factors of Hypoxemia after CPB in Children with Congenital Heart Disease

Objective:To investigate the risk factors of hypoxemia after CPB in congenital patients with congenital heart disease. Methods:A total of 98 children with congenital heart disease received from January 2016 to January 2017 were selected, all children underwent surgical treatment, CPB after 45 cases of hypox-emia, the remaining 53 cases did not appear hypoxemia, risk factors for hypoxemia after CPB were analyzed by single factor and Logistic multivariate regression. Results:The PaO2/FiO2 levels of 2h, 6h, 12h and 24h in children with hypoxemia were lower than those in non hypoxic group, and there was significant difference between the two groups ( P < 0.05) . Univariate analysis showed that there were significant differences in age, body weight, preoperative right-to-left shunt, preoperative pulmonary hypertension, and intraoperative venti-lation patterns ( P <0.01);Logistic multivariate regression analysis showed that low age, obesity, preoperative combined right to left shunt, pulmonary hypertension was congenital heart disease in children after CPB hypox-emia occurred in high risk factors. Conclusion:The incidence of hypoxemia in children with congenital heart disease is closely related to the low age, obesity and preoperative right -to -left shunt and pulmonary hyper-tension.