摘要目的 探讨婴幼儿先天性心脏病(简称先心)患儿经历体外循环手术后发生毛细血管渗漏综合征(capillary leak syndrome,CIS)的相关危险因素,为预防和控制CIS的发生提供依据.方法 回顾性研究浙江大学医学院附属儿童院2003年6月至2007年7月38例行体外循环手术后发生CIS的婴幼儿先心患儿的临床资料,对照组为随机抽取同期150例行体外循环手术后未发生CLS的婴幼儿先心患儿,对可能引起CLS的因素采用二分类进行单因素和多因素非条件Logistic逐步回归分析,以确定与CLS发病相关的独立危险因素;并对两组患儿术后治疗转归进行总结.结果 ①Logistic回归分析显示发生CIS的独立危险因素按OR值排序分别是:体外循环时间≥120 min(OR=10.353)、紫绀型心脏病(OR=6.912)、年龄≤1岁(OR=6.254)、体外循环温度≤25 ℃(OR=4.151).②CLS组行腹膜透析10例,死亡4例;对照组无腹膜透析病例及死亡病例.结论 体外循环时间、心脏病类型、年龄、体外循环温度是婴幼儿体外循环术后发生CLS的独立危险因素.

abstractsObjective To determine risk factors and treatments of capillary leak syndrome (CLS) in infants with congenital heart disease(CHD)after extracorporeal bypass (GBP) . Method A retrospective study of 38 infants with CIS and another 150 cases without CLS of a random choice who underwent extracoiporeal bypass from June 2003 to July 2007 was carried out.Several risk factors with statistical significance were screened out with uni-varite logistic regression analysis, and the independent rask factors of CLS were determined with inultivariate step-wise logistic regression analysis. The outcome of CIS infants was compared with infants of control group. Results Logistic analysis showed the risk factors of CLS were the duration of GBP ( OR = 10. 353) , type of CHD ( OR = 6. 912), age ( OR = 6. 254) and temperature of CBP ( OR = 4. 151) . Of the CLS infants cohort, 10 cases underwent peritoneal dialysis and 4 cases died. Conclusions The risk factors of CLS in infants after CBP are the length of time consumed during CBP, type of CHD, age and temperature of CBP.