法洛四联症矫正术后患者术后结局相关因素的研究。
Investigation of associated factors with post-operative outcomes in patients undergoing Tetralogy of Fallot correction.
作者信息
Amirghofran Ahmad Ali, Badr Jamshid, Jannati Mansour
机构信息
Associated Professor, Shiraz University of Medical Sciences, Shiraz, Iran.
Cardiovascular Surgeon, Shiraz University of Medical Sciences, Shiraz, Iran.
出版信息
BMC Surg. 2018 Mar 15;18(1):17. doi: 10.1186/s12893-018-0338-y.
BACKGROUND
Tetralogy of Fallot (TOF) is one of the congenital cardiac abnormality which occurs during embryonic time. Although surgical correction, especially early operation, is the best way to treat patients, still contributing factors in morbidity and mortality is controversial. The objective of this study is to investigate potential factors which might be correlated with post-operative outcomes of TOF.
METHODS
In this retrospective study, 349 monitored patients with TOF correction were selected. Median of age was 4 (0.66-8) year, 58% of patients were male and 42% were female. Time of inotropic drug, extubation time, and ICU stay were considered as post-operative outcomes which extension of each of them increased the risk of death.
RESULTS
Ventricular septal defect enlargement was associated with longer extubation time and ICU stay. Higher ratio of pre-operative haematocrit was correlated with mortality (0.047).
CONCLUSIONS
Results of this study demonstrated that haematocrit ratio before operation should be considered as a predictive factor, and patients with higher ratio of haematocrit require more care after operation. VSD enlargement is associated with longer extubation time and ICU stay.
背景
法洛四联症（TOF）是胚胎期发生的先天性心脏异常之一。尽管手术矫正，尤其是早期手术，是治疗患者的最佳方法，但发病和死亡的相关因素仍存在争议。本研究的目的是调查可能与TOF术后结果相关的潜在因素。
方法
在这项回顾性研究中，选取了349例接受TOF矫正监测的患者。年龄中位数为4（0.66 - 8）岁，58%为男性，42%为女性。使用正性肌力药物的时间、拔管时间和重症监护病房（ICU）停留时间被视为术后结果，这些时间的延长均增加死亡风险。
结果
室间隔缺损扩大与更长的拔管时间和ICU停留时间相关。术前血细胞比容比值较高与死亡率相关（0.047）。
结论
本研究结果表明，术前血细胞比容比值应被视为一个预测因素，血细胞比容比值较高的患者术后需要更多护理。室间隔缺损扩大与更长的拔管时间和ICU停留时间相关。
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