婴幼儿法乐四联症一期根治术后早期死亡的危险因素分析

Analysis on the risk factors affecting the early postoperative outcome in patients of infants and young children with tetralogy of Fallot

目的分析影响婴幼儿法乐四联症(TOF)一期根治治疗的危险因素,探讨法乐四联症一期根治的围术期处理方法。方法收集该院2003年1月至2012年11月期间行TOF根治术的195例患儿(分死亡组和存活组)的住院资料,进行统计学分析。结果单因素方差分析显示,年龄、McGoon比值(左、右肺动脉直径之和与膈平面降主动脉直径的比值)、体外循环时间及主动脉阻断时间在TOF患儿术后死亡与存活间差异具有统计学意义。多因素Logistic逐步回归分析:McGoon比值小于1.0,体外循环时间大于90min,主动脉阻断时间大于70min,年龄小于3个月,与TOF根治手术患儿发生术后死亡相关。结论婴幼儿期行TOF一期根治是安全可靠的,McGoon比值、体外循环时间及主动脉阻断时间、年龄是TOF一期根治治术后早期死亡的危险因素。

Objective Analysis the influence risk factors of infants and young children tetralogy of Fallot for radical treatment , and explore the perioperative treatment methods .Methods 195 cases（include death group and survival group）of hospitalized data of TOF resection in this hospital were collected in January 2003 to November 2012 ,then statistical analysis was done .Results Uni-variate analysis of variance showed ,age ,weight ,McGoon ratio ,cardiopulmonary bypass time and aortic clamping time were statisti-cally significant in two groups ,Multivariate Logistic regression analysis showed McGoon ratio 〈1 .0 ,cardiopulmonary bypass time〉90 min ,aortic clamping time〉70 min ,age〈3 months were related to the postoperative death of TOF radical operation .Conclu-sion It is safe and reliable of radical surgery in infants and young children ,McGoon ratio ,cardiopulmonary bypass time and aortic clamping time ,age are the risk factors of the postoperative death of TOF radical operation .