本文選題：Down綜合征 + 先天性心臟病��； 參考：《重慶醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的 通過(guò)對(duì)先天性心臟病合并DOWN綜合征患兒在心臟直視手術(shù)后監(jiān)護(hù)治療的臨床資料的進(jìn)行回顧性研究，探討Down綜合征是否為先天性心臟病術(shù)后并發(fā)癥的危險(xiǎn)因素。 方法 收集77名先天性心臟病合并Down綜合征的患兒資料，所有患兒均于2009年1月1日到2013年06月30日之間在我院心胸外科進(jìn)行心臟直視下心內(nèi)畸形矯治術(shù)，術(shù)后返回我院重癥監(jiān)護(hù)病房進(jìn)行術(shù)后監(jiān)護(hù)。同時(shí)隨機(jī)選取同期的77例先天性心臟病非DOWN綜合征術(shù)后患兒的臨床資料進(jìn)行比較分析。 結(jié)果 1、本研究中Down綜合征患兒心臟畸形類型主要為CAVSD和VSD，兩者共占83.12%。其中為CAVSD的患兒共有24人，約占31.17%，VSD的患兒有40人，，約占51.95%，ASD為5%，TOF為6%。 2、各組間患兒體重、性別、術(shù)前肺動(dòng)脈壓力無(wú)明顯差異，組間年齡比較第Ⅱ組小于第Ⅰ組。復(fù)雜先心病患兒的術(shù)中ACC時(shí)間及CPB時(shí)間明顯高于簡(jiǎn)單先心病患兒，但Ⅰ組與Ⅱ組，Ⅲ組與Ⅳ組無(wú)差異。 3、DOWN綜合征是復(fù)雜性先心病患兒術(shù)后LCOS的危險(xiǎn)因素，比較具有顯著性差異（P=0.04），但未發(fā)現(xiàn)其是簡(jiǎn)單先心患兒的危險(xiǎn)因素。 4、DOWN綜合征患兒術(shù)后具有更高的感染率，更長(zhǎng)的機(jī)械通氣時(shí)間及ICU住院時(shí)間。 5、DOWN綜合征患兒中死亡率升高，但未見(jiàn)顯著性。 結(jié)論 DOWN綜合征是先心病患兒術(shù)后并發(fā)癥特別是嚴(yán)重感染、機(jī)械通氣時(shí)間延長(zhǎng)、ICU住院時(shí)間延長(zhǎng)的危險(xiǎn)因素，但與肺部并發(fā)癥、總住院時(shí)間無(wú)關(guān)。DOWN綜合征是復(fù)雜先心病患兒術(shù)后LCOS的危險(xiǎn)因素，嚴(yán)重時(shí)可引起患兒肝、腎功能不全甚至死亡。本次研究尚未發(fā)現(xiàn)DOWN綜合征引起患兒術(shù)后死亡率增高。
[Abstract]:PurposeThe clinical data of children with congenital heart disease complicated with DOWN syndrome after open heart surgery were retrospectively studied to explore whether Down syndrome was a risk factor for postoperative complications of congenital heart disease.MethodFrom January 1, 2009 to June 30, 2013, 77 children with congenital heart disease complicated with Down syndrome were treated with intracardiac malformation in our hospital from January 1, 2009 to June 30, 2013.The patients returned to our intensive care unit for postoperative care.At the same time, 77 children with non-DOWN's syndrome of congenital heart disease were randomly selected and analyzed.Result1. In this study, the main types of cardiac malformations in children with Down syndrome were CAVSD and VSD, accounting for 83.12%.There were 24 patients with CAVSD, 40 patients with CAVSD and 51.95patients with CAVSD.2. There was no significant difference in body weight, sex and preoperative pulmonary artery pressure among groups, and the age of group 鈪

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