416例婴幼儿体外循环心内直视术后死亡病例分析

Mortality analysis of 416 open heart surgery in infant undergoing cardiopulmonary bypass

目的总结416例婴幼儿心内直视术患儿死亡病例的年龄分布特点及死亡原因.方法分析416例婴幼儿先天性心脏病患儿的临床资料,男249例,女167例,平均年龄(13.1±9.3)个月.结果416例婴幼儿体外循环心内直视术后共死亡21例,病死率5.0%;其中2004年1月～12月的144例患儿中死亡4例,病死率2.8%.婴幼儿的病死率在各年龄段的分布中以小于1岁的患儿较高.在死亡原因方面,以死于低心排综合征的婴幼儿比例最高,占21例死亡婴幼儿的57.1%(12/21),其次是死于呼吸功能衰竭的婴幼儿占21例死亡婴幼儿的28.6%(6/21).复杂先天性心脏病死亡病例在各年龄段死亡病例中占有较大比例.结论婴幼儿患儿体外循环心内直视术时年龄越小病死率越高,死于心、肺功能衰竭的患儿比例较高;因此在提高婴幼儿各种先心病矫治技术的同时应加强体外循环心脏手术中的心肺保护效果.

Objective To review the possible cause ot mortality in intants undergoing openheart surgery with cardiopulmonary bypass （CPB）. Methods Records of 416 infants with congenital heart disease who underwent open heart surgery were analyzed. There were 249 boys and 167 girls with age ranging from one to thirty-six months （average： 13.1 ±9. 3）. Results Of 416 cases, thirty- six patients died （5. 0%）. In 2004,the infant mortality rate of open heart operation was 2. 8%. Of all cases, the death rate of 1～6 month infants was highest （9. 6%）, those of 7～12 months, 13～25 month and 25～36 month being 6. 3% ,5.0% ,3. 1% respectively. The most common cause of rate was low cardiac output （57.1%）. Complex congenital heart disease accounted for most of the mortality. Conclusions The death rate increased with the decreasing age. The main cause of death was cardiopulmonary failure.