室间隔缺损术后患儿早期拔除气管插管的影响因素分析

目的探讨室间隔缺损(VSD)术后患儿早期拔除气管插管的影响因素。方法回顾性分析2020年6月至2022年5月102例VSD修补术后患儿的临床资料,根据术后拔除气管插管时间将患儿分为早期拔管组(≤8 h)和非早期拔管组(>8 h),比较两组术前、术中、术后各指标的差异,采用多因素Logistic回归模型分析影响早期拔除气管插管的独立危险因素。结果共纳入VSD术后患儿102例,其中术后早期拔管组66例,非早期拔管组36例。单因素分析显示,两组年龄、体质量、术前重度肺动脉高压、室缺大小、手术时间、体外循环(CBP)时间、主动脉阻断时间、术后低心排血量综合征差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,术前重度肺动脉高压,手术时间长、主动脉阻断时间长、CBP时间长、术后低心排血量综合征是影响VSD术后患儿早期拔除气管插管的独立危险因素。结论VSD室间隔缺损术后患儿早期拔除气管插管安全可行。术前重度肺动脉高压、手术时间、主动脉阻断时间、CBP时间、术后低心排血量综合征是影响VSD术后患儿早期拔除气管插管的独立危险因素。

Objective To analyze influencing factors of early tracheal extubation after operation of ventricular septal defect(VSD)in children.Methods The clinical data of 102 children who underwent VSD repair in our hospital from June 2020 to May 2022 were retrospectively analyzed.The children were divided into early extubation group(≤8 h)and non-early extubation group(>8 h)according to the time of postoperative extubation.The differences of preoperative,intraoperative and postoperative factors between the two groups were compared.The possible influencing factors were included in the multivariate Logistic regression model for analysis,and the independent risk factors affecting early extubation were finally identified.Results A total of 102 children with VSD were enrolled,including 66 cases in the early postoperative extubation group and 36 cases in the non-early postoperative extubation group.The univariate analysis demonstrated that age,body weight,preoperative severe pulmonary hypertension,diameter size of VSD,operation time,cardiopulmonary bypass time,aortic occlusion clamping time,postoperative low cardiac output syndrome were associated with early tracheal extubation after operation of VSD in children(P<0.05).The multivariate logistics regression analysis demonstrated that preoperative severe pulmonary hypertension,operation time,cardiopulmonary bypass time,aortic occlusion clamping time,postoperative low cardiac output syndrome were significantly associated with early tracheal extubation.Conclusion Early removal of tracheal intubation in children with ventricular septal defect after surgery is safe and feasible.Preoperative severe pulmonary hypertension,operation time,cardiopulmonary bypass time,aortic occlusion clamping time,postoperative low cardiac output syndrome are the main influencing factors of early tracheal extubation after operation of VSD in children.