探讨影响室间隔缺损术后恢复的危险因素

Explore the Risk Factors That Affect the Recovery after Surgery for Ventricular Septal Defect

摘要: 目的：明确影响室间隔缺损患儿术后恢复的危险因素，在临床上为促进室间隔缺损术后患儿快速恢复提供参考策略。方法：通过医院层面调查研究，对于2018年7月8日至2021年3月1日在青岛市妇女儿童医院就诊并实施室间隔缺损开胸手术的患儿进行基本信息、手术信息及住院信息的收集并整理。采用单因素分析和非条件Logistic回归分析对影响室间隔缺损术后恢复的相关因素进行统计学分析。结果：单因素分析结果显示手术路径是影响室间隔缺损的因素。非条件Logistic回归分析结果显示，室间隔缺损类型为膜周型(OR: 0.395; 95%CI: 0.155~0.999)；手术路径为右侧腋下切口(OR: 0.054; 95%CI: 0.005~0.587)是影响室间隔缺损患儿术后恢复的保护因素。结论：室间隔缺损类型为膜周型、手术路径为右侧腋下切口会降低患室间隔缺损患儿术后恢复的风险，有利于对患儿进行术前评估，为临床术前工作的实施提供参考策略。

Abstract: Objection: To identify the risk factors that affect the recovery after surgery for ventricular septal defect, and provide intervention strategy for the clinic. Methods: The study method was conducted to collect the information of children with ventricular septal defect from August 1, 2018 to April 30, 2019. The information includes basic information, surgical information, and hospitalization information. A logistic regression model was applied to assess the association between CHD and possible risk factors. Univariate analyses and unconditional logistic regression analysis were performed to assess the association between the recovery after surgery for ventricular septal defect and possible risk factors. Results: The result of univariate analyses indicated that surgical path was the factor of affecting the recovery after surgery for ventricular septal defect. Results from Logistic regression model indicated that, perimembranous ventricular septal defect (odds ratio, (OR): 0.395; 95% confidence interval, (CI): 0.155~0.999), right vertical infraaxillary thoracotomy (OR: 0.054; 95%CI: 0.005~0.587) were negatively associated with the recovery after surgery for ventricular septal defect. Conclusion: Perimembranous ventricular septal defect and right vertical infraaxillary thoracotomy could reduce the risk of recovery surgery for ventricular septal defect. Our findings are benefit to preoperative evaluation for patients and provide a reference strategy.