上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

完全性肺静脉异常连接患者手术后早期死亡危险因素分析

曹瑞雪1，郭颖2，陈笋1，徐让3   

  1. 上海交通大学 1.医学院附属新华医院小儿心血管科， 上海 200092； 2.医学院附属上海儿童医学中心心胸外科， 上海 200127； 3.医学院附属新华医院科研中心， 上海 200092
  • 出版日期:2015-04-28 发布日期:2015-04-29
  • 通讯作者: 徐让, 电子信箱: rang_xu@hotmail.com。
  • 作者简介:曹瑞雪（1989—）， 女， 硕士生; 电子信箱: caoruixue1502@163.com。

Analysis of risk factors of postoperative early death for patients with total anomalous pulmonary venous connection

CAO Rui-xue1, GUO Ying2, CHEN Sun2, XU Rang3   

  1. 1.Department of Pediatric Cardiology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China; 2.Department of Pediatric Cardiovascular and Thoracic Surgery, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127; 3.Scientific Research Center, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
  • Online:2015-04-28 Published:2015-04-29

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摘要：

目的 分析完全性肺静脉异常连接患者手术后早期死亡的危险因素。方法 收集52例不合并内脏异位、单心室等复杂畸形的简单肺静脉异常连接患者的临床资料，分析患者术后早期死亡（术后30 d内死亡）的危险因素。结果 52例患者中，术后早期死亡5例（9.62%）,其中4例体质量不足4 kg，1例体质量为4 kg；年龄均小于3个月，2例为新生儿；解剖分类：心上型2例，心内型1例，心下型2例。独立样本T检验和χ2检验分析结果显示：生存组与死亡组患者的体质量（P=0.005）、身长（P=0.021）、解剖分类（P=0.007）及术前左心房内径（P=0.016）的差异均有统计学意义；低体质量（≤4 kg）进入Logistic回归方程（OR=22.857，P=0.009）。结论 低体质量（≤4 kg）是完全性肺静脉异常连接患者术后早期死亡的独立危险因素。

关键词: 肺静脉异常连接, 手术, 危险因素

Abstract:

Objective To analyze the risk factors of postoperative early death for patients with total anomalous pulmonary venous connection (TAPVC). Methods The clinical data of 52 TAPVC patients without other complex anomalies such as heterotaxy syndrome or single ventricle were collected. The risk factors of postoperative early deaths (patients died within 30 days after surgery) were analyzed. Results Five patients died within 30 d after surgery (9.62%). Among them, 4 patients were less than 4 kg and 1 patient was 4 kg. Their ages were all less than 3 months and 2 were newborns. Two patients were superacardiac type; 1 was cardiac type; and 2 were infracardiac type. Results of T-test and Chi-squared test showed that differences of body weight (P=0.005), body length (P=0.021), anatomical classification (P=0.007), and LA diameter (P=0.016) of the survival group and the death group were statistically significant. The result of binary logistic regression analysis showed that the variable of underweight (≤4 kg) was included in the regression equation (OR=22.857, P=0.009). Conclusion Underweight (≤4 kg) is an independent risk factor of postoperative early death of patients with TAPVC.

Key words: total anomalous pulmonary venous connection, surgery, risk factors