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目的分析探讨婴幼儿先天性心脏病手术后早期心律失常的危险因素,以期降低其发生率。方法回顾性分析我院近3年的婴幼儿室间隔缺损手术的临床资料,比较分析早期心律失常发生的情况及原因。结果分析患儿348例,术后48h以内有97例出现各型心律失常(27.9%);手术前心胸比值≥0.6、合并肺部感染、合并肺动脉高压、术中主动脉阻断时间≥90min、术后血氧分压≤60mmHg、酸中毒、低心排者心律失常发生率更高;患儿年龄、VSD直径、手术方式等因素的不同,其心律失常发生率差异无统计学意义。结论心律失常是室间隔缺损修复手术后的常见早期并发症,心功能差、体外循环和阻断主动脉时间长、术后低心排是术后心律失常的重要原因。
Objective To analyze the risk factors of early arrhythmia in infants with congenital heart disease after surgery in order to reduce their incidence. Methods The clinical data of infantile ventricular septal defect surgery in recent 3 years in our hospital were retrospectively analyzed. The incidence and causes of early arrhythmia were analyzed. Results Analysis of 348 cases of children with arrhythmia (27.9%) occurred in 97 cases within 48 hours after operation. The cardiothoracic ratio before operation ≥ 0.6, with pulmonary infection, pulmonary hypertension, intraoperative aortic block time ≥90 minutes, Postoperative partial pressure of oxygen was less than or equal to 60mmHg, and the incidence of arrhythmia was higher in patients with acidosis and hypoglycemia. There was no significant difference in the incidence of arrhythmia between children with different ages, VSD diameters and surgical methods. Conclusion Arrhythmia is a common early complication after ventricular septal defect repair. Cardiac dysfunction, cardiopulmonary bypass and occlusion of the aorta are long arrhythmia. Postoperative low cardiac output is an important cause of postoperative arrhythmia.