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

先天性心脏病患儿改良Blalock-Taussig分流术后死亡原因分析及对策探讨

张婷婷1，顾晓蓉2，傅丽娟2   

  1. 上海交通大学 1.护理学院， 上海 200025； 2.医学院附属上海儿童医学中心心胸外科， 上海 200127
  • 出版日期:2013-09-28 发布日期:2013-09-29
  • 作者简介:张婷婷(1989—)， 女， 硕士生; 电子信箱: losemissing@aliyun.com。

Analysis and countermeasures of risk factors for death after modified Blalock-Taussig shunts in children with congenital heart diseases

ZHANG Ting-ting1, GU Xiao-rong2, FU Li-juan2   

  1. 1.School of Nursing, Shanghai Jiaotong University, Shanghai 200025, China; 2.Department of Cardiothoracic Surgery, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai 200127, China
  • Online:2013-09-28 Published:2013-09-29

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摘要：

目的 分析先天性心脏病患儿改良Blalock-Taussig分流术后围术期死亡原因，探讨相关护理对策。方法 在文献分析结合专家意见基础上，回顾性分析94例接受改良Blalock-Taussig分流术的先天性心脏病患儿的病例资料，采用单因素分析和Logistic回归分析围术期死亡的危险因素。结果 94例患儿中死亡18例，死亡率19.1%。单因素分析结果显示：体质量、身高、人造血管直径、手术年龄、术前酸中毒、延迟关胸、再手术是术后患儿死亡的危险因素。Logistic回归分析结果显示：术前酸中毒是术后患儿死亡的独立危险因素。结论 完善术前风险评估，预防术前酸中毒，加强术后监护，防治人造血管管道狭窄与堵塞，围术期持续营养支持，加强新生儿围术期监护，是降低先天性心脏病患儿Blalock-Taussig分流术后死亡率的主要对策。

关键词: 改良Blalock-Taussig分流术, 死亡原因, 先天性心脏病, 护理

Abstract:

Objective To analyze the causes of death after modified Blalock-Taussig shunts in children with congenital heart diseases, and explore the nursing strategies. Methods On the basis of literature review and expert consultation, the clinical data of 94 children with congenital heart diseases undergoing modified BlalockTaussig shunts were retrospectively analyzed, and univariate analysis and Logistic regression analysis were employed to explore the risk factors for death during perioperation. Results Eighteen of the 94 children died after operation, with the motality of 19.1%. Univariate analysis revealed that age, weight, height, the artificial blood vessel diameter, preoperative acidosis, delayed sternal closure and reoperation were death-related risk factors. Logistic regression analysis indicated that preoperative acidosis was the independent death-related risk factor. Conclusion Enhancing preoperative assessment of risk factors, preventing preoperative acidosis, conducting postoperative care, preventing stenosis and obstruction of the artificial blood vessel, performing perioperative nutritional supporting and strengthening perioperative care of newborn are the main care countermeasures to decrease the motality after modified Blalock-Taussig shunts in children with congenital heart diseases.

Key words: modified Blalock-Taussig shunts, cause of death, congenital heart disease, nursing