2011年至2015年中国儿童医院心脏手术的开展情况

The development situation of pediatric cardiac surgery in China from 2011 to 2015

目的总结2011年至2015年全国各地儿童医院/妇儿医院开展心脏手术的情况。方法对收集的5年间全国儿童医院/妇儿医院中开展的心脏手术问卷调查结果进行整理并做统计分析。不包括综合性医院所做的先天性心脏病(CHD)病例。调查的内容包括年心脏手术数量和年体外循环(ECC)手术数量,氧合器的使用种类和数量,年体外膜肺氧合(和心室辅助装置的开展情况。结果全国小儿的心脏手术数量从2011年的14 708例,上升到2015年的18 766例,总增长1.28倍,年平均增长率为6.28%。ECC手术数量从2011年的12 492例增长到2015年的15 454例,总增长1.24倍,年平均增长率为5.46%。体外生命支持技术的开展例数从2011年6例上升到2015年49例。各地区、医院间的手术数量差距较大。进口氧合器在市场中占主导地位。我国心脏手术的患儿趋向于低龄化和低体重化。结论 2011年至2015年,我国小儿心脏手术和ECC技术得到了快速的发展,但地区之间医疗水平的差异,医疗资源的分布不均,导致总体发展极不平衡。国内外氧合器的占有率差距较明显。CHD的早期手术治疗成为当今儿童心脏外科的发展特点。

Objective To summary the development of pediatric cardiac surgery in China from 2011 to 2015. Methods The information was collected from a questionnaire survey about the numbers of pediatric cardiac surgery,the surgery with extracorporeal circulation（ ECC）,the oxygenator,the extracorporeal membrane oxygenation（ ECMO） and ventricular assist device（ VAD） from ECC departments of all Children＇s hospitals in China. Results The number of pediatric cardiac surgery increased from 14708 cases in2011 to 18766 cases in 2015,at the same time,the ECC cases increased from 12492 to 15454. The increase was 1.28 and 1.24 times,and the annual increase rates were 6.28% and 5.46% respectively. The extracorporeal life support system（ ECLS） cases increased from6 to 49. There was a large gap between the numbers of operation in different hospitals and different areas. The numbers of imported membrane oxygenators still occupied a dominant position in the market. The patients of pediatric cardiac surgery tend to have lower age and lower body weight in China. Conclusion From 2011 to 2015,the development of pediatric cardiac surgery and ECC has been developed rapidly in China,while the difference between the medical level of different region and the distribution of medical resources which is not well-distributed lead to the unbalanced development. The imported membrane oxygenators are used more frequently than local oxygenators. Early surgical treatment of congenital heart disease（ CHD） in infants has become the focus of the development of cardiac surgery.