537例婴幼儿体外循环心内直视手术后死亡病例的年龄分布

The causes analysis for death patients after cardiopulmonary bypass in 537 cases infant with open heart surgery

目的 :总结 5 37例婴幼儿体外循环心内直视手术患者死亡病例的年龄分布特点及死亡原因。方法 :分析 5 37例婴幼儿先天性心脏病患儿的临床资料 ,男 336例 ,女 2 0 1例 ,年龄 1～ 36 (平均 13 2± 9 4 )个月。结果 :5 37例婴幼儿体外循环心内直视术后共死亡 36例 ,死亡率 6 7% ;其中 1999年 1月至12月的 185例患儿中死亡 8例 ,死亡率 4 3%。婴幼儿的死亡率在各年龄段的分布中以 <1岁的患儿较高 ,其中 1～ 6个月的患儿最高 (16 3% ) ;7～ 12个月的患儿死亡率 (8 1% ) ,13～ 2 4个月的患儿死亡率(6 3% ) ,2 5～ 36个月的患儿术后死亡率 (3 7% )。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 36例死亡婴幼儿的 5 0 % (18 36 ) ,其次是死于呼吸功能衰竭的婴幼儿占 36例死亡婴幼儿的33 3% (12 36 ) ,死于肾功能衰竭的占 11 1% (4 36 ) ,死于多脏器衰竭变竭的占 5 5 % (2 36 )。结论 :婴幼儿患者体外循环心内直视术时年龄越小死亡越高 ,死于心、肺功能衰竭的患者比例较高 ;因此对婴幼儿体外循环心脏手术时应加强术中的心脏保护效果。

Objective:To summarize the age characteristic and death reason for 537 cases infants on open\|heart surgery with cardiopulmonary bypass (CPB).Method:To analysis clinical date means for 537 cases infant with congenital heart disease,male 336 cases,femele 201 cases,the age is one to thirty\|six months (average was 13\^2±9\^4).Result:In 537 cases,there were thirty\|six cases death,death rate was 6\^7%.Among one to twelve months in 1999,there was 8 infants' death in 185 cases,the death rate was 4\^3%.In all cases,the 1～6 month infants death rate was highest (16\^3%),7～12 month 8\^1%,13～24 month 6\^3%,25～36 month 3\^7%.About the death reason,the highest death rate was low heart output syndrome (50%).Conclusion:The death rate increase according to the age decrease.The main death reason was exhausted of heart function and pulmonary function.Therefore,we should strengthen the protection with heart function and pulmonary function for infant during CPB. [