儿童心脏手术后的胆胸部
Juliane Kuster Bauer1, Nathalia Hocama1, Anna Clara Traub1
1Pequeno Príncipe Hospital, Desembargador Motta st., 80.250-060, Curitiba, PR, 1070, Brasil.
Pediatric cardiology
|August 10, 2023
概括
儿科心脏手术后的胆胸部与遗传综合征,更长的绕道时间,液体过载和SIRS有关. 早期识别这些风险因素可以降低相关的死亡率和感染率.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 胸部外科手术 胸部外科手术
- 临界护理医学 临界护理医学
背景情况:
- 胸腔,是儿科心脏手术期间胸管损伤的并发症,导致显著的发病率和死亡率.
- 增加资源利用与肌胸病有关,需要更深入地了解其风险因素和结果.
- 近年来,小儿心脏手术后胸病发病率呈现上升趋势.
研究的目的:
- 为了确定儿童心脏手术患者中胆胸病的风险因素,临床表现,并发症和治疗结果.
- 分析基洛托拉克斯在三级儿科医院环境中的分布和发病率.
- 评估基洛托拉克斯对患者死亡率和发病率的影响.
主要方法:
- 一项回顾性定量研究分析了166名胸患者和166名匹配对照患者的医疗记录.
- 2014年1月至2020年12月期间从巴西南部一家三级儿科医院收集的数据.
- 采用多变量分析和灵敏度分析来确定风险因素,并根据胆胸输出对比结果.
主要成果:
- 鉴定出胆胸的危险因素包括遗传综合征 (OR 2.298),长期心肺绕道 (>120分钟) (OR 2.410),术后液体过载 (OR 1.110) 和SIRS (OR 2.527).
- 胆胸病患者的死亡率增加了两倍 (p=0.021) 和感染发病率增加 (34.4%,p<0.001).
- 高输出胆胸 (>20毫升/公斤) 与不良结果有关.
结论:
- 遗传综合征,延长心肺旁路,液体过载和SIRS是小儿心脏手术后胆胸部严重风险因素.
- 在这种患者群体中,chylothorax显著增加了死亡率和感染率.
- 早期识别血液动力学变化和风险因素对于减轻与胆胸相关的发病率和死亡率至关重要.
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