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目的:探讨先天性心脏病合并其他畸形同期联合手术的可行性并总结手术经验及规避风险路径。方法:收集2015年5月至2019年12月首都儿科研究所附属儿童医院44例行同期联合手术患儿的临床资料，并收集同一时期在我院手术的患儿中经与联合手术患儿个体匹配后的44例患儿资料作为研究对象，并分为高风险组(17例)和低风险组(27例)。对比分析同期手术与分期手术不同组别患儿早期血流动力学指标及其他住院指标，以此评价同期联合手术方案是否更加优化。结果:同期组患儿均成功施行联合手术，其中4例术后出现并发症，院外死亡1例，均为高风险组患儿，其余患儿均治愈出院。同期组与分期组相比，患儿一般资料及术后早期血流动力学指标无明显差异，但手术及麻醉费用更低，平均缩短住院总时间5天，差异有统计学意义。相比于低风险组，高风险组同期联合手术患儿年龄、体质量明显偏低，合并畸形相对复杂，手术时间相对更长、术后早期心排出血量更低，术后可维持血流动力学稳定，但正性肌力药物评分(inotropicscore，IS)较高；术后气管插管时间、ICU滞留、总体住院时间延长，总体费用更多，差异有统计学意义；术后不良事件发生率更高。结论:先天性心脏病合并其他畸形患儿同期联合手术总体上安全可行，对于高风险组患儿，分期手术更加安全。如果不可避免同期联合手术，需通过个体化评估病情，制订详细的治疗方案以规避手术风险。“,”Objective:To explore the feasibility of simultaneous combined operation for congenital heart disease with other malformations and to summarize the experience of operation and the ways to avoid risks.Methods:From May 2015 to December 2019, the clinical data of 44 children undergoing simultaneous combined operation in our hospital were collected, and the data of 44 children who were matched with the children undergoing combined operation in the same period were collected as the research objects, which were divided into high-risk group(17 cases)and low-risk group(27 cases). To compare and analyze the early hemodynamic indexes and other hospitalization indexes of different groups of children undergoing simultaneous operation and staged operation, so as to evaluate whether the scheme of simultaneous combined operation is more optimized.Results:All the children in the same period successfully underwent combined operation, among which 4 cases had postoperative complications and 1 case died out of hospital, all of them were children in high-risk group, and the other children were cured and discharged. Compared with the staging group, there was no significant difference in general data and early postoperative hemodynamic indexes of children in the same period group, but the cost of operation and anesthesia was lower, and the average hospitalization time was shortened by about 5 days for each person, with statistical significance. Compared with the low-risk group, the children in the high-risk group were significantly lower in age and weight, complicated in deformity, longer in operation time, lower in early postoperative cardiac output, stable in hemodynamics after operation, but higher in inotropicscore score(IS). Postoperative endotracheal intubation time, ICU time and overall hospitalization time were prolonged, and the overall cost was more(n P<0.05) The incidence of postoperative adverse events was higher.n Conclusion:Simultaneous combined operation for children with congenital heart disease with other malformations is generally safe and feasible., Staging is safe for children in high-risk group, and if simultaneous combined surgery is unavoidable, the condition must be assessed individually and a detailed treatment plan must be developed to avoid surgical risks.