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在儿科心脏外科手术中在手术台上的输出管:对986名患者的多中心分析
Mustafa Kemal Avşar1, Yasin Güzel2, İbrahim Özgür Önsel3
1Division of Pediatric Cardiac Surgery, Department of Cardiovascular Surgery, Faculty of Medicine, Çukurova University, Adana, Turkey. mustafakavsar@gmail.com.
Pediatric cardiology
|June 18, 2025
概括
桌上输出管对于儿科心脏手术,特别是正手术来说是安全的. 然而,高风险患者,如患有低可塑性左心综合征 (HLHS) 患者,由于并发症发生率较高,需要仔细评估.
科学领域:
- 儿科心脏手术 儿科心脏手术
- 麻醉学 麻醉学
- 关键护理医学 关键护理医学
背景情况:
- 桌上输出管在儿科心脏手术中越来越多地使用,以减少呼吸机相关的并发症.
- 在各种先天性心脏病 (CHD) 种群中,其安全性和可行性需要进一步定义.
研究的目的:
- 评估各种心血管疾病手术的儿童桌上输出管的可行性,安全性和临床结果.
- 为了比较纠正和息手术组之间的结果.
主要方法:
- 对986名儿科患者 (7天至16岁) 进行回顾性多中心研究,在心脏病手术后接受桌上输出管 (2019-2025年).
- 患者分为纠正 (n=632) 和息 (n=354) 组.
- 主要结局:再输管和死亡率;次要结局:重症监护室/住院,呼吸机相关肺炎 (VAP).
主要成果:
- 总体而言,再灌输和死亡率分别为5.78%和1.22%.
- 纠正手术的再灌输率 (4.11%) 和死亡率 (0.63%) 明显低于息手术 (8.76%, 2.26%; p<0.01, p<0.05).
- 在低可塑性左心综合征 (HLHS) 和大风肺突变术中,并发症率最高;在格伦和方丹手术中,并发症率低. 没有报告VAP病例.
结论:
- 桌上输出管是儿科心脏外科手术中安全和可行的策略,特别是在纠正手术和选择单心室息时.
- 建议对高风险生理学,如HLHS和分流依赖的循环进行谨慎处理.
- 彻底的术后评估对于优化结果至关重要.
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