术前日志GAR预测儿科心脏外科手术中的术后并发症:一项回顾性队列研究
Min-Xiao Li1, Yu-Zhen Zhang1, Bo Feng1
1Department of Anesthesiology, Kunming Children's Hospital, Yunnan, China.
Journal of cardiothoracic and vascular anesthesia
|November 6, 2025
概括
手术前的马-氨基转移酶与白蛋白比率 (logGAR) 可以预测先天性心脏病 (CHD) 手术的儿童的麻醉相关并发症. 较高的logGAR水平表明不良结果的风险增加,例如长时间的通风和ICU停留.
科学领域:
- 儿科麻醉学 儿科麻醉学
- 心血管外科心血管外科
- 生物标志物研究 生物标志物研究
背景情况:
- 与麻醉相关的并发症是儿科先天性心脏病 (CHD) 手术中的一个重要问题.
- 长时间的机械通风,再输管和长时间的ICU停留是常见的不良事件.
- 确定这些并发症的预测标记对于改善患者的治疗结果至关重要.
研究的目的:
- 评估手术前的马-氨基转移酶与白蛋白比率 (logGAR) 作为儿科心脏病患者麻醉相关并发症的预测指标.
- 评估logGAR之间的关联,反映氧化应激,炎症和营养状况以及术后并发症.
主要方法:
- 追溯队列研究,包括942名为心脏病进行心肺旁路术的儿科患者 (2018-2024年).
- 预手术日志GAR的计算.
- 主要结局分析:机械通风≥72小时,48小时内再输管,ICU停留时间>90百分位,或死亡率.
主要成果:
- 17.4%的患者 (164/942) 经历了并发症.
- 在患有并发症的患者中,手术前的logGAR显著更高 (中位数为-0.97比-1.32,p < 0.001).
- 每个单位增加的logGAR与增加的并发症风险相关 (aOR 2.41;95% CI 1.49-3.95),观察到的最强的关联在-1.62和0.467.
结论:
- 手术前的logGAR是小儿心脏病手术后麻醉相关并发症的重要预测因素.
- 将logGAR纳入麻醉前评估可能会提高这些脆弱患者的术后风险分层.
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