摘要
目的 探讨婴幼儿室间隔缺损合并重症肺炎的治疗经验。方法 回顾性分析我院2014年1月至2015年4月收治的1岁以下室间隔缺损合并肺炎行呼吸机辅助的患儿30例（试验组）的临床资料,其中男16例、女14例,年龄0.9~12.0（4.6±2.9）个月,体质量3.0～8.8（5.6±1.4）kg,行亚急症手术治疗。同期未合并呼吸道感染的室间隔缺损患儿30例（对照组）,其中男10例、女20例,年龄0.7～19.0（4.9±4.8）个月,体质量2.6～12.0（5.8±2.1）kg,行择期手术治疗。比较两组院内死亡率、心脏重症监护室（CICU）滞留时间、住院时间等。结果 试验组术后死亡1例,对照组无死亡患儿。试验组总住院时间[（15.73±6.44）d vs.（10.16±2.16）d,P=0.002]、术后呼吸机辅助时间[（28.00±15.72）h vs.（12.17±9.10）h,P=0.000]比对照组延长,差异有统计学意义。两组主动脉阻断时间、体外循环时间、监护室滞留时间差异无统计学意义（P〉0.05）。两组患儿均门诊随访6个月,患儿肺炎发病率减低,生长发育状况、活动耐量明显改善。结论 婴幼儿室间隔缺损合并重症肺炎,术前应积极呼吸机辅助呼吸改善心功能、肺功能,及时行手术治疗,尽管住院时间略长,但整体效果满意。
Objective To investigate the clinical effectiveness of early repair in infants with large ventricular septal defect complicated with pneumonia. Methods We retrospectively analyzed the clinical data of 30 infants who underwent emergency operation in our hospital between January 2014 and April 2015. There were 16 males and 14 females at age of 0.9-12.0 （4.6±2.9） months and with weight of 3.0-8.8 （5.6±1.4） kg. They were diagnosed as ventricular septal defect combined with pneumonia as a trial group. There were other 30 patients without pneumonia,10 males and 20 females, aged of 0.7-19.0 （4.9±4.8） months, weighing 2.6-12 （5.8±2.1） kg, as a control group. All the patients were followed up for 6 months. Results One patient died in the trial group. None died in the control group. There were statistical differences in length of hospital stay （15.73±6.44 d vs. 10.16±2.16 d, P=0.002） and mechanical ventilation time （28.00±15.72 h vs.12.17±9.10 h, P=0.000） between the trial group and the control group. There was no statistical difference in aortic cross-clamping time, cardiopulmonary bypass time, or CICU residence time （P〉0.05）. All the patients were followed up for 6 months. Incidence of pneumonia reduced, growth status and exercise tolerance significantly improved. Conclusion Emergency operation for the infants who suffered from ventricular septal defect with severe pneumonia is efficient and effective. Early mechanical ventilation may be beneficial to the procedure.
出处
《中国胸心血管外科临床杂志》
CAS
CSCD
2016年第11期1066-1069,共4页
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
基金
河北省科技计划项目(13277715D)~~
关键词
先天性室间隔缺损
婴幼儿
重症肺炎
亚急症手术治疗
Congenital ventricular septal defect
Infant
Severe pneumonia
Emergency operation
