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目的 :总结 5 37例婴幼儿体外循环心内直视手术患者死亡病例的年龄分布特点及死亡原因。方法 :分析 5 37例婴幼儿先天性心脏病患儿的临床资料 ,男 336例 ,女 2 0 1例 ,年龄 1～ 36 (平均 13 2± 9 4 )个月。结果 :5 37例婴幼儿体外循环心内直视术后共死亡 36例 ,死亡率 6 7% ;其中 1999年 1月至12月的 185例患儿中死亡 8例 ,死亡率 4 3%。婴幼儿的死亡率在各年龄段的分布中以 <1岁的患儿较高 ,其中 1～ 6个月的患儿最高 (16 3% ) ;7～ 12个月的患儿死亡率 (8 1% ) ,13～ 2 4个月的患儿死亡率(6 3% ) ,2 5～ 36个月的患儿术后死亡率 (3 7% )。在死亡原因方面 ,以死于低心排综合征的婴幼儿比例最高 ,占 36例死亡婴幼儿的 5 0 % (18 36 ) ,其次是死于呼吸功能衰竭的婴幼儿占 36例死亡婴幼儿的33 3% (12 36 ) ,死于肾功能衰竭的占 11 1% (4 36 ) ,死于多脏器衰竭变竭的占 5 5 % (2 36 )。结论 :婴幼儿患者体外循环心内直视术时年龄越小死亡越高 ,死于心、肺功能衰竭的患者比例较高 ;因此对婴幼儿体外循环心脏手术时应加强术中的心脏保护效果。
OBJECTIVE: To summarize the age distribution characteristics and causes of death of 5 37 infants with open heart surgery under cardiopulmonary bypass. Methods: The clinical data of 537 infants with congenital heart disease were analyzed. There were 336 males and 320 females, aged from 1 to 36 (average 13 2 ± 94) months. Results: Among 37 cases of infants and young children undergoing cardiopulmonary bypass, 36 died and the mortality rate was 67%. Among them, 8 of 185 children died from January 1999 to December 1999, with a mortality rate of 43%. Infant mortality was higher in children aged <1 year among children of all ages, with the highest in children 1-6 months (16.3%) and in children aged 7-12 months (8% 1%), 13 ~ 24 months of child mortality (63%), 25 ~ 36 months of postoperative mortality in children (37%). In terms of the cause of death, the highest proportion of infants died of low cardiac output syndrome, accounting for 50% of the 36 infants (18 of 36), followed by 36 infants who died of respiratory failure (36%) were 33 3% (12 36%) who died of renal failure, and 5 5% (2 36%) died of multiple organ failure. Conclusion: Infants and young children undergoing cardiopulmonary bypass open heart surgery, the younger the higher the death rate, the higher the proportion of patients died of heart failure and pulmonary failure; therefore, the cardioprotective effect should be strengthened during cardiopulmonary bypass surgery in infants and young children .