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目的观察小儿复杂先天性心脏病体外循环术后血乳酸浓度与术后脓毒症发病率的临床相关性。方法回顾性分析我院2012年1月至2014年5月手术治疗复杂先天性心脏病小儿114例,男59例,女55例,年龄(6.17±3.19)个月,体重(6.54±1.61)kg,身高(63.79±8.48)cm,记录病例的体外循环时间、主动脉阻断时间、术后乳酸浓度、术后脓毒症发病情况。分为正常乳酸组(<2.25 mmol/L,n=44)、高乳酸组(≥2.25 mmol/L并≤5 mmol/L,n=41)、乳酸酸中毒组(>5 mmol/L,n=29),比较分析各组之间各指标的差异。结果乳酸酸中毒组的体外循环时间、主动脉阻断时间、脓毒症发病率分别高于正常乳酸组和高乳酸组(均P<0.05),而正常乳酸组和高乳酸组之间无统计学差异(P>0.05)。结论复杂先天性心脏病小儿在体外循环下行心脏畸形矫正术,术后乳酸浓度明显升高时并发脓毒症的风险增高。
Objective To observe the clinical correlation between blood lactic acid concentration and postoperative sepsis incidence after complicated cardiopulmonary bypass in children with complicated congenital heart disease. Methods A retrospective analysis of 114 cases of complicated congenital heart disease in our hospital from January 2012 to May 2014 was performed, including 59 males and 55 females, with a mean age of (6.17 ± 3.19) months and weight of (6.54 ± 1.61) kg , Height (63.79 ± 8.48) cm, recording the cardiopulmonary bypass time, aorta blocking time, postoperative lactate concentration, postoperative sepsis incidence. Lactic acidosis group (> 2.5 mmol / L, n = 44), lactate acidosis group (≥2.25 mmol / L and ≤5 mmol / L, n = 41) = 29), comparative analysis of the differences between the various indicators of each group. Results The lactic acidosis group had higher cardiopulmonary bypass time, aortic cross-clamping time and sepsis incidence than normal lactic acid group and high lactic acid group (all P <0.05), while there was no statistical difference between normal lactic acid group and high lactic acid group Learning difference (P> 0.05). Conclusions Children with complicated congenital heart disease underwent cardiopulmonary deformity correction after cardiopulmonary bypass. The risk of sepsis is increased when the concentration of lactate is significantly increased.