摘要
目的探讨法洛四联症(tetralogy of Fallot,TOF)术后出现急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)的危险因素,为预防及治疗提供依据。方法329例TOF根治患儿,分为未发生ARDS组(Ⅰ组,304例)和发生ARDS组(Ⅱ组25例)。全组ARDS发生率为7.6%。以年龄、性别、体重、Nakata指数等作为观察变量,进行统计学分析。结果Ⅱ组死亡3例,病死率为12%。单因素分析显示,Ⅱ组与Ⅰ组比较,年龄低,Nakata指数小[(165±43)mm2/m2vs.(201±32)mm2/m2],体外循环时间长[(150±258)min vs.(108±38)min],跨环补片比例多(88%vs69.7%),主动脉/肺动脉比值(AO/PA)大,均有显著性差异。Logistic回归显示,年龄﹤4个月、Nakat指数﹤140mm2/m2、体外循环时间﹥150min、AO/PA﹥2.5是TOF术后ARDS的危险因素。结论TOF根治术后ARDS的主要危险因素是低龄、Nakata指数小、体外循环时间长、肺动脉发育差。
Objective To explore the risk factors for acute respiratory distress synderome （ARDS） after corrective operation of Tetralogy of Fallot （TOF） in order to offer prophylactic and therapeutic evidence. Methods 329 consecutive patients with TOF undergoing corrective operation were divided into two groups： Group Ⅰ included 304 cases without ARDS and Group Ⅱ included 25 patients with ARDS. The morbility of ARDS in the whole group was 7.6%. Statistical analysis was performed with age, sex, body weight and Nakata index as variables. Results Three patients died in group Ⅱ and the mortality was 12%. Univariate analysis indicated that compared with Group Ⅰ , there were younger age, smaller Nakata index [（165±43）mm^2/m^2 vs. （201±32）mm^2/m^2], longer cardiopulmonany bypass time [（150±258）min vs. （108±38）mini, higher percentage of transannular patch （88% vs 69.7%） and larger ration of AO/PA in Group Ⅱ. The difference between two groups was significant. Logistic regression results showed that the risk factors for ARDS after corrective operation of TOF included age 〈4 months, Nakata index 〈140mm^2/m^2, cardiopulmonany bypass time 〉150min and the ratio of AO/PA 〉 2.5. Conclusions The risk factor of ARDS after corrective operation of TOF are younger age, low Nakata index, low time of cardiopulmonany are younger age, lwo Nakata index, long time of cardiopulmonany bypass and hypogenesis of pulmonany artery.
出处
《北京医学》
CAS
2009年第4期208-210,共3页
Beijing Medical Journal
关键词
法洛四联症
呼吸窘迫综合征
危险因素
Tetralogy of Fallot Acute respiratory distress syndrome（ARDS） Risk factor
