低体重婴幼儿先天性室间隔缺损外科修补术后延迟恢复的风险因素分析

目的 探讨体重≤5.0kg的低体重婴幼儿行室间隔缺损修补术延迟恢复及并发症的风险因素.方法 回顾性分析2016年1月至2019年7月在我院接受室间隔缺损修补术且体重≤ 5.0 kg 86例患者的临床资料,其中男31例、女55例,年龄17～266(80.3±40.4)d,体重2.5～5.0(4.4±0.6)kg.室间隔缺...

Risk factors for deleyed recovery after surgical closure of congenital ventricular septal defect in infants with low weight

Objective To reveal the risk factors for delayed recovery and complications in infants with weight≤5.0 kg after surgical ventricular septal defect(VSD)closure.Methods We retrospectively reviewed a consecutive series of86 patients with weight≤5.0 kg who were admitted to our institution for surgical VSD closure between January 2016 and July 2019,including 31 males and 55 females with an age of 17-266(80.3±40.4)d and a weight of 2.5-5.0(4.4±0.6)kg.The VSDs were divided into perimembranous(n=65,75.6%),subaortic(n=17,19.8%)and subaortic combined muscular types(n=4,4.7%).Mechanical ventilation(MV)time≥24 h or ICU stay≥72 h were defined as delayed recovery.Death,sudden circulatory arrest,complete heart block requiring a permanent or temporary pacemaker implantation,neurological complications,reoperation(for residue shunt or valvular regurgitation),reintubation and diaphragmatic paralysis were considered as significant major adverse events.Results There was no death,reoperation due to residual VSD or neurological complication.Totally 51(59.3%)patients had MV timec≥24 h and 51(59.3%)patients stayed in the ICU≥72 h.Two(2.3%)patients required temporary pacemaker and six(7.0%)patients required reintubation.During the followup of 3-36(15.8±8.8)months,1 patient died of pneumonia after discharge,5 patients suffered mild tricuspid valve regurgitation and 1 patient suffered decreased left ventricular systolic function in the follow-up.No aortic valve injuries occurred.Conclusion For patients whose weight≤5.0 kg,short-term results of surgical VSD closure are excellent.Low weight and age may prolong MV time;low birth weight and pulmonary hypertension may prolong ICU stay,but are not independent risk factors.