摘要
目的探讨新生儿危重先天性心脏病术前危重状态的识别及针对危重状态的治疗策略。方法收集2019年9月至2020年9月我院的收治新生儿手术患儿60例,其中53例接受手术治疗,5例自动出院,2例死亡。手术新生儿中位年龄14 d,男37例,女16例。以术前出现危重状态分组,比较两组术后临床指标及预后情况。结果53例接受手术治疗的新生儿中,术前出现危重状态14例,未出现危重状态39例。两组新生儿术前体重、手术年龄无明显差异,危重组新生儿术前调整时间显著多于非危重组新生儿[(3.5±2.2)d,(1.2±2.5)d]。危重组术后呼吸机使用时间明显多于非危重组[(382.6±262.8)h,(187.0±260.2)h]。危重组新生儿ICU住院时间明显高于非危重组[(23.5±12.8)d,(12.8±12.9)d]。两组新生儿在术后死亡率、渗漏、二次插管等方面均无明显差异,危重组新生儿术后延迟关胸发生率明显多于非危重组。结论新生儿危重先天性心脏病术前出现危重状态将影响预后,术前危重状态出现概率与年龄不相关,做好术前危重状态评估和系统调整策略尤为重要。
Objective To explore the identification of the critical state of neonates with critical congenital heart disease before surgery and the treatment strategy for the critical state.Methods From September 2019 to September 2020,60 cases of neonatal surgery children were admitted to our hospital.Among them,53 cases received surgical treatment.Among the remaining 7 cases,5 cases were discharged automatically and 2 cases died.The median age of neonates undergoing surgery was 14 days.There were 37 males and 16 females.The postoperative clinical indicators of the two groups were divided into groups according to the preoperative critical condition,and the clinical prognosis of the two groups were compared.Results From September 2019 to September 2020,a total of 53 neonates underwent surgical treatment,14 neonates in critical condition before surgery,39 neonates without critical condition.There was no significant difference in preoperative weight or age between the two groups of newborns.Preoperative ICU adjustment time of critical recombination neonates was more than that of non-critical recombination neonates[(3.5±2.2)d vs(1.23±2.5)d].The use time of ventilator after critical reorganization was significantly higher than that of non-critical reorganization(382.64±262.822 h vs 187±260.183 h).In terms of ICU hospitalization time,the hospitalization time of critically newborns was significantly higher than that of non-critical newborns[(23.5±12.8)d vs(12.8±12.9)d].There were no significant differences in postoperative mortality,leakage,or secondary intubation between two groups.The incidence of postoperative delayed chest closure in critically newborns was significantly higher than that of non-critical newborns.Conclusion Critical state of neonates with critical congenital heart disease will affect the prognosis after surgery.The probability of preoperative critical state is not related to age.It is particularly important to evaluate the critical state and adjust the patient’s condition before surgery.
作者
郑林
周宇子
王澎
曾敏
胡静
王旭
ZHENG Lin;ZHOU Yu-zi;WANG Peng;ZENG Min;HU Jing;WANG Xu(Department of PICU,Pediatric Cardiovascular Surgery,Cardiovascular Institute and Fuwai Hospital,Chinese Academy of Medical Science and Peking Union Medical College,Beijing 100037,China)
出处
《中国分子心脏病学杂志》
CAS
2021年第3期3991-3994,共4页
Molecular Cardiology of China
基金
国家重点研发计划项目资助(2017YFC1308100)
中国医学科学院临床与转化基金资助(2019XK320053)。
关键词
新生儿
危重症
临床预后
并发症
Neonatal
Critically ill
Clinical prognosis
Complications
