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目的探讨婴幼儿先心病术后急性肺损伤的危险因素。方法选取河北医科大学第一医院2006年10月至2014年10月行先心病手术治疗的婴幼儿2 786例,分为两组,术后发生急性肺损伤患儿24例为观察组,术后未发生急性肺损伤患儿2 762例为对照组,对患儿术后发生急性肺损伤的相关因素,行单因素分析和多因素Logistic回归分析。结果婴幼儿先心病术后急性肺损伤的发生率为0.86%。单因素分析显示,观察组与对照组患儿性别比较差异无统计学意义(P>0.05);患儿年龄、肺炎病史、术前左心室射血分数、术前是否贫血、手术类型、体外循环时间、深低温停循环的应用、术后低血压、术后输血量、术后呼吸机辅助呼吸时间比较差异有统计学意义(P均<0.01)。多因素Logistic回归分析显示,年龄<6个月、有肺炎病史、术前左心室射血分数<50%、有术前贫血、开放手术、体外循环时间≥60 min、有深低温停循环的应用、有术后低血压、术后输血量≥500 ml、术后呼吸机辅助呼吸时间≥6 h是婴幼儿先心病术后急性肺损伤的危险因素(P均<0.01)。结论年龄、肺炎病史、术前左心室射血分数、术前贫血、手术类型、体外循环时间、深低温停循环的应用、术后低血压、术后输血量、术后呼吸机辅助呼吸时间均是婴幼儿先心病术后急性肺损伤的危险因素。
Objective To investigate the risk factors of acute lung injury in infants with congenital heart disease. Methods A total of 2 786 infants and young children undergoing primary cardiomyopathy were enrolled in the First Hospital of Hebei Medical University from October 2006 to October 2014. The infants were divided into two groups. Twenty-four children with acute lung injury after operation were selected as the observation group, A total of 2 762 children with acute lung injury were selected as the control group. Univariate and multivariate Logistic regression analysis were used to analyze the related factors of acute lung injury. Results The incidence of acute lung injury in infants with CHD was 0.86%. Univariate analysis showed that there was no significant difference in sex between the observation group and the control group (P> 0.05). The age, history of pneumonia, preoperative left ventricular ejection fraction, preoperative anemia, type of surgery, cardiopulmonary bypass The application of time, deep hypothermic circulatory arrest, postoperative hypotension, postoperative blood transfusion, postoperative ventilator assisted breathing time were significantly different (all P <0.01). Multivariate logistic regression analysis showed that patients with age less than 6 months had a history of pneumonia, preoperative left ventricular ejection fraction <50%, preoperative anemia, open surgery, cardiopulmonary bypass time ≥60 min, and application of deep hypothermic circulatory arrest , Postoperative hypotension, postoperative blood transfusion≥500 ml, postoperative ventilator assisted breathing time≥6 h were the risk factors for acute lung injury in infants with CHD (all P <0.01). Conclusions Age, history of pneumonia, preoperative left ventricular ejection fraction, preoperative anemia, type of surgery, cardiopulmonary bypass, application of deep hypothermic circulatory arrest, postoperative hypotension, postoperative blood transfusion, postoperative ventilator assisted breathing time Is a risk factor for acute lung injury in infants with CHD.