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华西医学  2012 

10 kg及以下体重婴幼儿心脏直视术后呼吸机使用时间相关因素分析

DOI: CNKI:51-1356/R.20120115.1541.006, PP. 21-24

Keywords: 机械通气,低体重婴幼儿,先天性心脏病

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Abstract:

目的 探讨≤10kg体重婴幼儿心脏直视术后呼吸机使用时间的相关因素。方法 从2005年3月-2011年6月,选择纳入接受心脏直视手术的体重≤10kg的先天性心脏病婴幼儿,分析各项围术期指标与术后呼吸机使用时间的关系,讨论该类婴幼儿术后呼吸机使用时间决策。结果 共纳入体重≤10kg的婴幼儿42例,呼吸机使用时间(42.74±52.55)h,中位数20.88h;发现术后2h入量(mL/kg),术后4、8、16h总入量(mL/kg)与术后呼吸机使用时间相关(P<0.05),术后呼吸机使用时间与患儿ICU入住时间约成线性相关(P<0.05)。结论 影响低体重婴幼儿心脏直视术后呼吸机使用时间是术后液体管理,实施“限制性液体管理”治疗策略可能会促进患儿的术后快速康复。术后液体管理如何具体影响患儿呼吸机使用时间,影响患儿的预后,尚需进一步研究。Objective Toevaluatethefactorsrelatedtothepostoperativemechanicalventilation(MV)durationinlow-weightinfantsweighinglessthan10kghavingundergoneopencardiacsurgery.Methods FromMarch2005toJune2011,infantslessthan10kgundergoingcongenitalcardiacsurgerywereincludedinthisresearch.Weanalyzedtherelationshipbetweenvariousperi-operativeindexesandthedurationofMV,anddiscussedthedecisionforventilationtimefortheseinfantpatients.Results Atotalof42infantswereincludedinourstudy.Theventilationtimewas(42.74±52.55)hourswithamedianof20.88hours.Thepostoperativesecond-hourfluidintakeandthetotalintakeoffluidathour4,8,and16wererelatedtothedurationofmechanicalventilation(P<0.05).AndtheventilationtimehadalinearrelationshipwiththeICU-staytime(P<0.05).Conclusions Thepostoperativefluidmanagementisassociatedwiththedurationofmechanicalventilationforlow-weightinfantshavingundergoneopencardiacsurgery.“Fluidcontrollingmanagement”mayfacilitatequickrecoveryoftheinfantpatients.However,asforhowthefluidshouldbemanaged,howthefluidmanagementinfluencesventilationtimeandtheprognosis,moreresearchisneeded.

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