5kg以下婴儿室间隔缺损术后早期气管拔管的影响因素分析

Analysis of influencing factors of early tracheal extub-ation after infant ventricular septal defect 5 kg below

目的:探讨5 kg以下室间隔缺损(VSD)患儿早期脱机的影响因素。方法:回顾性分析2014年5月至2019年5月,我院收治的172例体质量5 kg以下的VSD患儿的临床资料,依据术后机械通气时间分为:早期拔管组(机械通气时间<8 h)和非早期拔管组(机械通气时间不<8 h),将单因素分析具有统计学意义的变量进行多因素Logistic回归分析,进一步明确影响早期脱机的因素。结果:收治5 kg以下VSD患儿共172例,术后早期脱机拔管24例(14.0%),非早期脱机拔管148例(86.1%),心胸比、主动脉阻断时间、手术时间、CPB时间、术前合并肺部感染、术前合并肺动脉高压是影响早期脱机的质量要因素。结论:对于5.0 kg以下以VSD为主要心内畸形的患儿术后早期脱机是安全可行的。

Objective:To analyze the influencing factors of early tracheal extubation after operation of ventricular septal defect(VSD)in children under 5 kg.Methods:The clinical data of 172 VSD children with weight below 5 kg from May 2014 to May 2019 were retrospectively analyzed.According to the postoperative me-chanical ventilation time,the early extubation group(mechanical ventilation time less than 8 h)and the non-early extubation group(mechanical ventilation time is not less than 8 h)were divided into multivariate regres-sion analysis of variables with statistical significance.Results:There were 172 cases with ventricular septal de-fect below 5 kg,24 cases(14.0%),148 cases(86.1%),cardiothoracic ratio,aortic occlusion time,operation time,CPB time,preoperative pulmonary infection and preoperative pulmonary hypertension were important fac-tors affecting early weaning.Conclusions:For children with VSD as the main intracardial malformation below 5.0 kg,early postoperative tracheal extubation is safe and feasible.