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埃及儿童心脏直视手术后早期心律失常的患病率及危险因素

The Prevalence and Risk Factors of Early Arrhythmias Following Pediatric Open Heart Surgery in Egyptian Children.

作者信息

Gawad Tarek Ahmed Abdel, Elguindy Waleed Mohamed, Youssef Omneya Ibrahim, Abosalem Tamer Ashraf

机构信息

Pediatric Department, Faculty of Medicine, Ain Ainshams University, Cairo, Egypt.

Coronary Care Unit, Abu El Reesh Hospital, Cairo University, Giza, Egypt.

出版信息

Open Access Maced J Med Sci. 2017 Dec 5;5(7):940-944. doi: 10.3889/oamjms.2017.177. eCollection 2017 Dec 15.

Abstract

AIM

This study aimed to assess the prevalence of early postoperative arrhythmias after cardiac operation in the pediatric population, and to analyse possible risk factors.

MATERIAL AND METHODS

Cross-sectional study included 30 postoperative patients, with age range four up to 144 months. They were selected from those admitted to the Cardiology Unit in the Pediatric department of Ain Shams University hospitals, after undergoing cardiopulmonary bypass (CPB) surgery for correction of congenital cardiac defects. All patients had preoperative sinus rhythm and normal preoperative electrolytes levels. All patients' records about age, weight, type of surgery, intraoperative arrhythmias, cardiopulmonary bypass time, ischemic time and use of inotropic drugs were taken before they were admitted to the specialised pediatric post-surgery intensive care unit (ICU).

RESULTS

Arrhythmia was documented in 15 out of 30 patients (50%). Statistically significant difference between the arrhythmic and non-arrhythmic group were recorded in relation to the age of operation (23 vs 33 months), weight (12 vs. 17 kg), ischemic time (74.5 vs. 54 min), cardiopulmonary bypass time (125.5 vs. 93.5min), inotrope use (1.6 vs. 1.16) and postoperative ICU stay (5.8 vs. 2.7 days), P<0.05.

CONCLUSION

Early postoperative arrhythmias following surgery for congenital heart disease are relatively frequent in children (50%). Younger age, lower body weight, longer ischemic time and bypass time, and more inotrope use are all risk factors for postoperative arrhythmias and lead to increase the hospital stay.

摘要

目的

本研究旨在评估小儿心脏手术后早期心律失常的发生率,并分析可能的危险因素。

材料与方法

横断面研究纳入30例术后患者,年龄范围为4至144个月。他们选自艾因夏姆斯大学医院儿科心脏病科收治的患者,这些患者接受了体外循环(CPB)手术以纠正先天性心脏缺陷。所有患者术前均为窦性心律,术前电解质水平正常。在所有患者入住专门的小儿术后重症监护病房(ICU)之前,记录了他们的年龄、体重、手术类型、术中心律失常、体外循环时间、缺血时间和使用的强心药物等所有信息。

结果

30例患者中有15例(50%)记录到心律失常。心律失常组和非心律失常组在手术年龄(23个月对33个月)、体重(12千克对17千克)、缺血时间(74.5分钟对54分钟)、体外循环时间(125.5分钟对93.5分钟)、强心药物使用情况(1.6对1.16)和术后ICU住院时间(5.8天对2.7天)方面存在统计学显著差异,P<0.05。

结论

先天性心脏病手术后小儿早期心律失常相对常见(50%)。年龄较小、体重较低、缺血时间和体外循环时间较长以及更多地使用强心药物都是术后心律失常的危险因素,并导致住院时间延长。

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