新生儿和婴儿先天性心脏病术后万古霉素低谷浓度发生状况分析

Analysis of occurrence of low vancomycin trough concentration after cardiac surgery in neonates and infants with congenital heart disease

目的了解新生儿和婴儿先天性心脏病外科手术后万古霉素血清谷浓度偏低发生状况并探讨其相关因素。方法利用医院信息系统收集2017年1月至2018年6月广东省人民医院收治的月龄不大于6个月,先天性心脏病手术后接受了万古霉素治疗并监测了万古霉素稳态谷浓度≥1次患儿的病历资料进行回顾性分析。收集患儿一般情况,稳态血清谷浓度,使用万古霉素前及使用期间血肌酐浓度,手术情况等资料进行统计分析。结果纳入分析的患者39例,检测次数为41例次;日龄(75.51±44.06)d,体质量(4.15±1.07)kg。2组患儿的性别、日龄、体质量,万古霉素使用前和使用期间血肌酐浓度比较,差异均无统计学意义(P>0.05);低浓度组与达标浓度组患儿万古霉素血清谷浓度比较,差异有统计学意义[(6.15±2.30)μg/mL vs.(15.92±3.52)μg/mL,t=-10.759,P=0.000)]。结论婴儿先天性心脏病术后万古霉素血清谷浓度偏低的发生率为63.4%,应注意监测万古霉素血清谷浓度。

Objectives To determine the occurrence of low vancomycin trough concentration after cardiac surgery in neonates and infants with congenital heart disease.Methods The clinical date of neonates and infants with congenital heart disease,with age<6 months,cardiac surgery postoperatively receiving vancomycin treatment,having vancomycin trough concentration monitoring date,hospitalized in Guangdong General Hospital from January 2017 to June 2018 were retrospectively reviewed.General information,surgery information,vancomycin trough concentration and serum creatinine of these infants were collected.Results Totally 39 neonates and infants with 41 concentrations were included in this study.These neonates and infants aged(75.51±44.06)days,weight was(4.15±1.07)kg.General information and serum concentration of creatinine between the two groups were not significantly different(P>0.05).Vancomycin trough concentration in low concentration group and non-low concentration group were(6.15±2.30)μg/mL and(15.92±3.52)μg/mL respectively,and they were significantly different(t=-10.759,P=0.000).Conclusions Incidence of low vancomycin trough concentration in neonates and infants with congenital heart disease after cardiac surgery is 63.4%.Monitoring vancomycin trough concentration is necessary among these neonates and infants.