摘要
目的探究血管活性药物评分对先天性心脏病儿童外科治疗后生存状况的影响。方法选取于2015年6月-2018年6月间在河南省儿童医院进行外科治疗的先天性心脏病儿童438例,根据随机数表法将患儿分为对照组和实验组,每组各219例。对照组患者不参与评分,实验组患者进行血管活性药物评分,收集临床资料,并对术后第1个24 h和第2个24 h血管活性药物评分进行统计,均值和最大值采用相应的检验方法,对血管活性药物评分和患者外科治疗厚度生存状况进相关性行分析。结果对比两组的病情,除房间隔缺损(ASD)、室间隔缺损(VSD)之外,患儿还患有完全性房室间隔缺损(CAVC)、右室双出口(DORV)、大动脉转位(TGA)、肺动脉瓣闭锁(PVA)和完全性肺静脉异位连接(TAPVC)等复杂性先天性心脏病的差异均无统计学意义;实验组进行血管活性药物评分结果显示,VIS(24 max)患儿的死亡率(3.65%)、严重病情结局率(19.18%)和乳酸高值(55.25%)均明显高于VIS(48 max)患儿(1.83%、11.42%、2.74%),仅有乳酸高值、VIS(24max)影响患者外科治疗后的生存状况,且差异具有统计学意义(P<0.05)。实验组死亡率以及三种严重病情状况(缺氧缺血性脑损、心肺复苏和血液净化)的比率较对照组低(0.91%~4.11%),即实验组进行外科治疗后的生存状况明显优于对照组,且差异具有统计学意义(P<0.05)。结论先天性心脏病儿童在外科治疗后进行血管活性药物评分,可以有效提高对病情的监控程度,使医生及时采取治疗措施,极大地改善了患儿的生存状况,降低死亡率,值得临床推广使用。
Objective To investigate the effect of vasoactive drug scores on the survival of children with congenital heart disease after surgical treatment. Methods A total of 438 children with congenital heart disease who underwent surgical treatment in the hospital from June,2015 to June,2018 were enrolled. The patients were divided into control group and experimental group according to the random number table method, and there were 219 cases in each group. The patients in the control group did not participate in the scoring. The patients in the experimental group were scored with vasoactive drugs, and the clinical data of the patients were collected. The statistical mean and maximum value of the first 24 h and the second 24 h vasoactive drug scores were determined by the corresponding test methods. Correlation analysis was performed between vasoactive drug scores and patient surgical treatment of thickness survival. Results The patients were compared with atrial septal defect(ASD)and ventricular septal defect(VSD). Patients also had complete atrioventricular septal defect(CAVC), right ventricular double outlet(DORV), and aortic transposition. There were no significant differences in complex congenital heart disease(TGA), pulmonary valve atresia(PVA), and complete pulmonary venous connection(TAPVC). The vasoactive drug scores in the experimental group showed VIS(24 max). The mortality rate(3.65%), the severity of the disease(19.18%), and the high lactic acid value(55.25%)were significantly higher than those of VIS(48 max)patients(1.83%, 11.42%, 2.74%). VIS(24 max) affected the survival of patients after surgical treatment, and the difference was statistically significant(P<0.05). The mortality rate of the experimental group and the three serious conditions(hypoxic ischemic brain damage, cardiopulmonary resuscitation and blood purification) were lower than those of the control group(0.91%~4.11%), that is, the survival of the experimental group after surgical treatment was obvious. It was superior to the control group,and the difference was statistically significant(P<0.05). Conclusion The vasoactive drug scores in children with congenital heart disease can effectively improve the monitoring of patients’ condition, so that timely seeing doctor and taking treatment measwes can greatly improve the patient’s living condition and reduce the mortality. It is worthy of clinical promotion.
作者
和东阳
吴跃伟
HE Dong-yang;WU Yue-wei(Cardiothoracec Surgey,Children’s Hospital,Zhengzhou University/Henan Children’s Hospital/Zhengzhou Children’s Hospital,Zhengzhou,450000,China)
出处
《黑龙江医学》
2020年第3期307-310,共4页
Heilongjiang Medical Journal
关键词
血管活性药物评分
先天性
心脏病
儿童
生存状况
Vasoactive drug score
Congenital
Heart disease
Children
Living condition
