婴幼儿室间隔缺损外科治疗近期效果的多因素分析

Multivariate Analysis of the Short-term Outcome of Surgical Treatment of Ventricular Septal Defect in Infants and Children

【目的】通过对过去10年间婴幼儿室间隔缺损(ventricularseptaldefect,VSD)手术术前、术中各因素的回顾性多因素分析,以发现其中影响外科治疗近期效果的重要因素。【方法】对1993年1月至2002年12月111例手术后确诊且主要诊断为先天性心脏病室间隔缺损的月龄≤36个月的患儿,加以入选分析。对可能与手术近期死亡率相关的各因素分别行二项分类logistic回归;在单因素分析的基础上,对单因素分析中与手术近期死亡率相关的各因素进行多因素逐步向前(wald)logistic回归分析。【结果】本组死亡11例,近期死亡率9.9%。术前心功能分级和右心室流出道切口,对月龄≤36个月婴幼儿VSD修补术手术死亡率的影响具有统计学意义(P<0.05)。【结论】术前心功能分级和右心室流出道切口是影响月龄≤36个月婴幼儿VSD修补术手术近期死亡率的危险因素。

[ Objective ] To investigate the risk factors that influence the short-term outcome of surgical treatment of ventricular septal defect （VSD） in infants and children through regressive multivariate analysis in last ten years. [Methods] 111 cases of infants and children （age≤36 months） who had surgical treatment of VSD from Jun. 1993 to Dec. 2002 were eligible for entry into the study. Each factor, which may have effect on postoperative death of the patients, were tested by binary logistic regression. And then, a multivariate binary stepwise forward （wald） logistic regression was performed. [Results] In the group 11 cases died and the early mortality was 9.9%. Effects of preoperative New York Heart Association （NYHA） classification and right ventricular incision were statistically significant on the early death of infants and children （age≤36 months） after surgical treatment of VSD （P〈 0.05）. [Conclusion] Preoperative NYHA classification and right ventricular incision are factors influence early death of VSD in infants and children（age ≤ 36 months）.