临床儿科杂志 ›› 2014, Vol. 32 ›› Issue (9): 872-.doi: 10.3969 j.issn.1000-3606.2014.09.018

• 综合报道 • 上一篇    下一篇

先天性食管闭锁合并简单先天性心脏病新生儿预后危险因素分析

陈凤,张钰,李禄全   

  1. 重庆医科大学附属儿童医院新生儿诊治中心 重庆市住院医师规范化培训基地 儿童发育疾病研究省部共建教育部重点实验室 重庆市儿科学重庆市重点实验室 重庆市儿童发育重大疾病诊治与预防国际科技合作基地( 重庆 400014)
  • 收稿日期:2014-09-15 出版日期:2014-09-15 发布日期:2014-09-15
  • 通讯作者: 李禄全 E-mail:liluquan123@163.com

Risk factor for mortality in neonate with congenital esophageal atresia and simple congenital heart disease

CHEN Feng, ZHANG Yu, LI Luquan   

  1. Neonatal Diagnosis and Treatment Center, Children’s Hospital of Chongqing Medical University, Training Base of Clinical Resident Standard Training in Chongqing, Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing, Chongqing International Science and Technology Cooperation Center for Child Development and Disorders, Chongqing 400014, China
  • Received:2014-09-15 Online:2014-09-15 Published:2014-09-15

摘要:  目的 探讨先天性食管闭锁(CEA)合并简单先天性心脏病(CHD)新生儿预后不良的危险因素。方法 回顾性分析1998年—2013年收治并手术的CEA合并简单CHD患儿的临床资料,包括一般情况、实验室检查、术后并发症等,并比较存活和死亡患儿的临床资料。结果 75例患儿纳入最终研究,存活67例,死亡8例,病死率10.67%。死亡及存活患儿的出生胎龄,出生体质量,入院日龄,手术日龄,手术持续时间,手术前、手术当天、痊愈出院/死亡前最近的一次血常规、肝肾功能、电解质、血气分析的差异均无统计学意义(P均>0.05);死亡患儿的呼吸衰竭和心力衰竭的发生比例均高于存活患儿,差异有统计学意义(75%、9.0%,P=0.000;50%、1.5%,P=0.000)。结论 CEA合并简单CDH患儿死亡可能与并发呼吸衰竭和心力衰竭有关。

Abstract:  Objective:??To investigate the risk factors for mortality in neonates with congenital esophageal atresia (CEA) and simple congenital heart disease (CHD) including atrial septal defect (ASD), ventricular septal defect (VSD) and patent ductus arteriosus (PDA). Methods The medical records of neonates with CEA and simple CHD who had surgery in Children’s Hospital of Chongqing Medical University from 1998 to 2013, were analyzed retrospectively. Factors including neonatal demographics, laboratory results and complications after surgery were compared between survivor and non-survivor groups. Results Seventy five cases were included in this study and the mortality was 10.67% (8/75). There was no significant difference between nonsurvivor group (n=8) and survivor group (n=67) in factors such as gestational age, birth weight, age of admission, age at surgery, duration of surgery, full blood examination, serum electrolytes, blood gases, prevalence of septicemia, pneumothorax, and cold lesion syndrome. However, the prevalence of respiratory failure and heart failure in non-survivor group was higher than that in survivor group (75% vs. 9%, P=0.000; 50% vs. 1.5%, P=0.000, respectively). Conclusions The poor outcome among neonates with CEA plus simple CHD might be associated with respiratory failure and heart failure.