完全性肺静脉异位引流手术的危险因素分析

目的 分析完全性肺静脉异位引流（TAPVC）患儿手术的预后，寻找影响手术死亡的危险因 素。方法 选取2008 年6 月-2016 年6 月郑州大学第三附属医院实施TAPVC 纠治手术的患儿102 例，用 Logistic 回归方法对可能导致手术死亡的因素进行分析。结果 患儿住院死亡9 例（8.8%）。其中，心上型5 例， 心内型2 例，心下型2 例；6 例死于低心排，3 例死于肺部感染。Logistic 回归分析发现，肺部感染、解剖分型、 阻断时间、体外循环时间及体重分级为影响术后近期死亡的危险因素（P <0.05）。结论 TAPVC 患儿实施手 术治疗，可以取得比较满意的效果，肺部感染、解剖分型、阻断时间、体外循环时间及体重分级是影响手术 效果的危险因素。

Risk factors of total anomalous pulmonary venous connection operation in infants

Objective To summarize the experience of surgery of total anomalous pulmonary venous connection (TAPVC) in infants, and analyze the risk factors. Methods A total of 102 consecutive neonates undergoing surgical correction of total anomalous pulmonary venous connection in the Third Affiliated Hospital of Zhengzhou University between June 2008 and June 2016 were selected. There were 57 males and 45 females with the mean weight of 5.5 kg at the mean age of 3 m. Clinical variables possibly associated with death were examined using logistic regression analysis. Results There were 9 operative deaths (8.8%), including 5 patients of supracardiac type, 2 patients of intracardiac type, and 2 patients of infracardiac type; 6 died of low cardiac output, and 3 died of pneumonia. Logistic regression analysis showed that preoperative pulmonary infection, anatomic classification, aortic clamping time, time of cardiovascular bypass and weight were the risk factors for postoperative mortality. Conclusions TAPVC operation for infants can obtain satisfactory results. Preoperative pulmonary infection, anatomic classification, aortic clamping time, cardiopulmonary bypass time and weight are the risk factors for operation.