【摘要】 目的:探讨小儿先心病心脏术后感染的临床特点以及特异性危重程度评分对其预后的影响。方法:回顾性分析2017年1月～2017年12月在我院就诊的小儿先心病行心脏手术治疗348例患儿临床资料,记录患儿感染发生率、感染部位、病原菌分布特点,探讨导致患儿出现感染的危险因素,分析特异性危重程度评分对患儿预后的影响。结果:348例患儿中有26例出现感染,感染率为7.47%;主要分布于下呼吸道,占56.52%,其次为手术部位,占19.56%,第三为胃肠道,占15.22%,最后为泌尿系统,占8.69%。46例感染患儿共分离出25株病原菌,其中以革兰阴性菌为主,15株,占60.00%;其次为革兰阳性菌,7株,占28.00%,第三为真菌,3株,占12.00%。对可能导致小儿先心病患儿出现感染的7项单因素进行分析,结果表明,年龄、机械通气时间、心脏体外循环时间、抗菌药物使用、住院时间等因素与患儿出现感染有关;通过logistic分析,结果表明年龄、机械通气时间、心脏体外循环时间、抗菌药物使用、住院时间等因素是导致患儿出现感染的独立危险因素。感染组患儿特异性危重评分为(17.56±3.02)分;未感染组患儿特异性危重评分为(11.02±2.56)分;感染组患儿评分明显高于未感染组患儿,二者对比具有显著性差异。结论:患儿心脏术后感染主要发生于下呼吸道,革兰阴性菌为主要病原菌,年龄、机械通气时间、心脏体外循环时间、抗菌药物使用、住院时间等因素是导致患儿出现感染的独立危险因素,且特异性危重程度评分与患儿预后密切相关,特异性危重程度评分越高,患儿预后越差。更多还原

【Abstract】 Objective To investigate the clinical characteristics and prognosis of congenital heart disease (CHD) after cardiac surgery.Methods 348cases of children with congenital heart disease in our hospital in 2017 year were analyzed retrospectively.The incidence of infection,the location of infection and the distribution of pathogenic bacteria were recorded,the risk factors leading to the infection of the children were discussed,and the prognosis of the specific critical degree was analyzed for the prognosis of the children.The influence.Results Of the 348 cases,26 cases were infected,the infection rate was 7.47%,mainly in the lower respiratory tract,accounting for 56.52%,followed by the surgical site,19.56%,third of the gastrointestinal tract,15.22%,and the last of the urinary system,accounting for 8.69%.Among the 46 infected children,68 pathogenic bacteria were isolated,among them,Gram-negative bacteria were mainly gram-negative,15,accounting for 60.00%,followed by Gram-positive bacteria,7,28.00%,third fungi,3,12.00%.The analysis of 8 single factors that may lead to infantile congenital heart disease showed that age,mechanical ventilation time,cardiopulmonary bypass time,antibiotic use,hospitalization time and other factors were associated with infection in children;the results of logistic analysis showed that age,mechanical ventilation time,cardiopulmonary bypass time,antibiotic use,hospital time and other factors are independent risk factors that lead to infection in children.The specific critical score of children in the infection group was (17.56 + 3.02),and the specific critical score was (11.02 + 2.56) scores in the uninfected group (11.02 + 2.56).The scores of the children in the infection group were significantly higher than those in the uninfected group,and the difference between the two groups was significantly different.Conclusion The infection mainly occurs in the lower respiratory tract after heart operation,and Gram-negative bacteria are the main pathogens.Age,mechanical ventilation time,cardiopulmonary bypass time,antibiotic use,hospital time and other factors are independent risk factors that lead to infection in children.The prognosis of children is closely related.The higher the specific critical score,the worse the prognosis of children.更多还原