婴幼儿先心病术后拔管前血气分析对早期撤机的影响

Before extubation blood gas factors analysis of postoperative early withdraw ventilator influencing in infants with congenital heart diseases

目的分析拔管前血气分析对婴幼儿先心病术后早期撤机的影响。方法收集2014年1月1日至2017年1月1日在心儿ICU监护的婴幼儿先心病术后拔管前血气分析指标,分析与术后早期撤机的关系。结果 (1)单因素分析结果提示术后早期撤机率与拔管前血气分析中PH、HCO_3^-、Lac^-、SaO_2、A-aDO_2、RI及OI均有关(均P<0.05)。(2)非条件Logisitic回归分析提示PH、HCO_3^-及Lac^-是独立影响因素,其OR值(95%CI)分别为50.1(80～311)、1.51(1.12～2.02)和0.18(0.05～0.65)。结论拔管前SaO_2高、A-aDO_2≤100 mmHg、RI低及OI高有利于婴幼儿先心病术后早期撤机;PH、HCO_3^-及Lac^-是独立影响因素,虽在早期撤机组中稍差,但在基本正常值范围内仍可实现早期撤机。

Objective To analyze the blood gas analysis before extubation related to early withdraw venti-lator in infants with congenital heart disease. Methods Collecting the blood gas analysis datas before extubation ofinfants with congenital heart disease who were treated with CICU in our hospital from 2014. 01.01 to 2017.01.01,To analyze the relationship between early withdraw ventialtor and the blood gas analysis before extubation. Results 1.Univariate analysis showed that infants with congenital heart disease early postoperative rate of weaningwere related to blood gas analysis before extubation with PH,HCO_3^-,Lac^-,SaO_2,A-aDO_2,respiratory index andoxygenation index（P〈0.05）. 2.The results of non conditional logisitic regression analysis showed that PH,HCO_3^-and Lac^-were independent factors,the value of OR（95%CI）were 50.1（80-311）,1.51（1.12-2.02）and 0.18（0.05-0.65）. Conclusion In infants with congenital heart disease before extubation SaO_2 high,A-aDO_2≤ 100 mmHg,respiratory index low and oxygenation index high were the important factors of postoperative early weaning;The PH,HCO_3^-and Lac^-were independent factors,even though early withdrawal unit blood gas analysis before ex-tubation the index is inferior to late withdrawal unit′s,it can also achieve early weaning in the basic normal valuerange.