先天性心脏病小婴儿术后喂养不耐受危险因素分析
High-Risk Factors of Feeding Intolerance in Infants with Congenital Heart Dis-ease after Surgery
黄阿娟 1邹有群 2郑曼利 2孙新 2温树生 1刘玉梅3
作者信息
- 1. 广东省心血管病研究所 广东省人民医院(广东省医学科学院),广州 510080
- 2. 南方医科大学附属广东省人民医院(广东省医学科学院)新生儿科,广州 510080
- 3. 南方医科大学附属广东省人民医院(广东省医学科学院)新生儿科,广州 510080;广东省心血管病研究所 广东省人民医院(广东省医学科学院),广州 510080
- 折叠
摘要
目的 探讨小婴儿先天性心脏病(先心病)术后喂养不耐受(feeding intolerance,FI)发生的高危因素及临床特征.方法 回顾性分析2021年12月至2022年12月在广东省人民医院行先心病手术后,0～3个月龄的患儿的临床资料,分为术后FI组和术后非FI组.结果 纳入159例患儿,术后非FI组101例,术后FI组58例.早产儿术后FI发生率显著高于足月儿,差异有统计学意义(P<0.05).术后FI组患儿比术后非FI组出生质量更低,差异有统计学意义(P<0.05).术后FI组患儿机械通气时间、镇静及镇痛药物使用时间均较非FI组长,差异有统计学意义(P<0.05).绘制受试者工作特征曲线(receiver operating characteristic curve,ROC),寻找术后机械通气时间、镇静药、镇痛药使用时间最佳阈值分别为5.8 d、5.5 d、5.5 d.多因素回归分析提示男性患儿、术后使用抗生素、术后机械通气时间长是先心病术后发生FI的独立影响因素(P<0.05).结论 早产、低出生体质量、男性患儿、术后机械通气时间长、术前或术后感染(使用抗生素)是先心病术后发生FI的高危因素.
Abstract
Objectives To explore the high-risk factors and clinical characteristics of feeding intolerance in infants with congenital heart disease after surgery.Method This study was a single center retrospective study.The clinical data of 0-3 months old infants with congenital heart disease who underwent surgery in Guangdong Provincial People's Hospital from December,2021 to December 2022 were analyzed.They were divided into feeding intolerance group and feeding tolerance group based on their postoperative feeding condition.Results This study included a total of 159 pediatric patients,including 101 in the feeding tolerance group and 58 in the feeding intolerance group.The results showed that the incidence of feeding intolerance in premature infants was significantly higher than that in term infants(P<0.05).Infants in feeding intolerance group had a lower birth weight than those in feeding tolerance group(P<0.05).The postoperative mechanical ventilation duration were longer in feeding intolerance group than that in feeding tolerance group(P<0.05).The duration of sedative and analgesic drug use in feeding intolerance group was longer than that in feeding tolerance group(P<0.05).Using postoperative mechanical ventilation duration,sedative medication use duration,and analgesic medication use duration as predictive factors,plot receiver operating characteristic curve(ROC)curves to find the optimal indicator threshold.The results indicated that the thresholds for postoperative mechanical ventilation duration,sedative medication use duration and analgesic medication use duration were 5.8 days,5.5 days and 5.5 days,respectively.Logistic regression analysis showed that male gender,postoperative use of antibiotics,longer duration of mechanical ventilation after surgery were the independent factors of feeding intolerance in infants with congenital heart disease after surgery(P<0.05).Conclusions Premature birth,low birth weight,male,long postoperative ventilator support duration,and preoperative or postoperative infection(using antibiotics)are risk factors for postoperative feeding intolerance in infants with congeni-tal heart disease.
关键词
先天性心脏病/婴儿/喂养不耐受Key words
congenital heart disease/infant/feeding intolerance引用本文复制引用
出版年
2024
NETL
NSTL
万方数据