Kết quả trung hạn phẫu thuật chuyển gốc động mạch tại Bệnh viện Nhi Trung ương giai đoạn 2010 - 2020=Midterm outcomes after the arterial switch operation at Vietnam National Children’s Hospital in the period 2010-2020

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Tác giả: Vương Anh Doãn, Hữu Nhật Nguyễn, Hữu Ước Nguyễn, Lý Thịnh Trường Nguyễn, Quý Khương Nguyễn, Tuấn Mai Nguyễn

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Nghiên cứu y học (Đại học Y Hà Nội), 2024

Mô tả vật lý: tr.185-195

Bộ sưu tập: Metadata

ID: 244725

Thêm vào giỏ

Nghiên cứu nhằm đánh giá kết quả trung hạn phẫu thuật chuyển gốc động mạch và xác định một số yếu tố nguy cơ liên quan đến tử vong sớm, phẫu thuật lại tại Bệnh viện Nhi Trung ương giai đoạn 2010 - 2020. Cỡ mẫu gồm 558 bệnh nhân với tuổi phẫu thuật trung vị là 27(36) ngày, giới nam chiếm 73,5%, thời gian cặp động mạch chủ trung vị là 108 (53,8) phút. Tỷ lệ tử vong sớm sau phẫu thuật là 5,9%, tỷ lệ tử vong muộn sau phẫu thuật là 1,1%. Qua phân tích hồi quy Cox cho thấy thời gian cặp động mạch chủ dài hơn (HR =1,01, KTC 95%: 1,01 - 1,02, p <
0,01), bệnh nhân cân nặng thời điểm phẫu thuật <
3kg (HR = 3,56, KTC 95%: 1,8 - 7,1, p <
0,01), bệnh nhân phải cặp lại động mạch chủ (HR = 5,2, KTC 95%: 1,5 - 19,8, p <
0,01) là những yếu tố nguy cơ liên quan đến tử vong sớm. Tỷ lệ bệnh nhân phẫu thuật lại là 3,7%, trong đó bệnh thất phải hai đường ra thể chuyển gốc động mạch là yếu tố liên quan đến phẫu thuật lại trong nghiên cứu của chúng tôi (HR = 10,1, KTC 95%: 2,7 - 38, p <
0,01).The purpose of the study was to evaluate the midterm outcomes and risk factors for early mortality and reoperation in patients undergoing an arterial switch operation at Vietnam National Children’s Hospital from 2010 to 2020. 558 patients with the median age at +27 (36) days, 73.5% of patients were male, median aortic cross-clamp time was 108 (53.8) minutes. Overall early mortality was 5.9%, and late mortality was 1.1%. Multivariate Cox regression showed: prolonged aortic cross-clamp time (HR = 1.01, 95% CI: 1.01-1.02, p <
0.01), weight less than 3kg at the time of ASO (HR = 3.56, 95% CI: 1.8 - 7.1, p <
0.01), and need for secondary aortic cross-clamp (HR = 5.2, 95% CI: 1.5 - 19.8, p <
0.01) as risk factors for overall early mortality. The rate of reoperation was 3.8%, patients who were diagnosed with DORV-TGA were at risk for reoperation (HR = 10.1
95% CI: 2.7 - 38, p <
0.01).

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