婴幼儿体外循环术后早期死亡原因分析

目的总结1 172例婴幼儿心内直视手术患儿死亡病例的年龄分布特点及死亡原因,以期进一步提高治疗水平。方法分析2001年1月至2010年12月1 172例婴幼儿先天性心脏病患儿的临床资料,男701例,女471例,平均年龄（12.8±9.5）个月。按手术年代时间段和年龄及病种不同进行分组分析。结果 1 172例婴幼儿体外循环心内直视术后共死亡46例,病死率3.92%;其中急诊手术56例,死亡7例,病死率12.5%;2005年1月至2010年12月的878例患儿中死亡20例,病死率2.28%。婴幼儿的病死率在各年龄段的分布中以小于1岁的患儿较高。死亡原因为：低心排血量综合征18例、呼吸衰竭14例、肾功能衰竭10例,多器官功能衰竭4例。结论婴幼儿体外循环心内直视手术时年龄越小病死率越高,死于心、肺功能衰竭的患儿比例较高;外科技术水平的提高,体外循环管理的改进,术后监护水平的提高可降低患儿的病死率。

Early death causes in infants undergoing cardiopulmonary bypass

Objective To review the possible causes of mortality in infants undergoing open-heart surgery with cardiopulmonary bypass(CPB),in order to provide better operation and decrease the mortality rate.Methods Records of 1172 in infants with congenital heart disease who undergoing open heart surgery were analyzed.There were 701 males and 471 females with age ranging from 3 to 36 months(average: 12.8±9.5 months).Results Of 1172 cases,46 patients died(3.92%).7 patients died after emergency operation with mortality of 12.5%(7/56).Between January 2005 and December 2010,the infants’ mortality rate of open heart operation was 2.28%.Of all cases,the death rate of 3-6 months infants was highest(8.22%),the main causes of death were low cardiac output syndrome(18 cases),respiratory failure(14 cases),kidney failure(10 cases) and multiple organ failure(4 cases).Conclusion The death rate of infants undergoing cardiopulmonary bypass is negative related to patients’ age.The main cause of death is cardiopulmonary failure.Appropriate and intensive postoperative care can decrease the mortality.