Analysis of risk factors of lower extremity venous thrombosis in pediatric patients after surgery for congenital heart disease
10.3760/cma.j.cn101070-20190217-00105
- VernacularTitle:先天性心脏病婴幼儿术后下肢静脉血栓形成的高危因素分析
- Author:
Kaiyuan WU
1
;
Bin LI
;
Ying HUA
;
Taibing FAN
Author Information
1. 河南省人民医院，阜外华中心血管病医院儿童心脏中心重症监护室，郑州 450003
- From:
Chinese Journal of Applied Clinical Pediatrics
2020;35(5):375-378
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the risk factors of puncture- or catheter-related lower extremity venous thrombosis after surgery for congenital heart disease(CHD).Methods:A retrospective analysis was performed on 683 children with venipuncture or venous catheterization in the lower extremities who underwent surgery for CHD in Children′s Heart Center Intensive Care Unit, Henan Provincial People′s Hospital from January 2017 to December 2018, and there were 55 children suspected thrombosis, among whom, 26 cases of thrombosis confirmed by ultrasound were included in the thrombosis group, and 29 cases without thrombosis seen by ultrasound were assigned to the control group.A comparative analysis was carried out to see whether there were statistical differences in the possible risk factors between the 2 groups, and the risk factors of puncture- or catheter-related lower extremity venous thrombosis after operation of CHD.Results:The incidence of puncture- or catheter-related lower extremity venous thrombosis after surgery for CHD was 3.81% (26/683 cases). The differences between the thrombosis group and the control group in age (62 d vs.92 d), weight [(3.92±0.66) kg vs.(4.61±0.86) kg], CHD postoperative critical score (Vasoactive-Ventilation-Renal score, VVR)[(29.58±15.50) scores vs.(22.14±11.72) scores], peak blood lactate within 24 hours after surgery [(3.59±0.66) mmol/L vs.(1.71±1.13) mmol/L], postoperative blood transfusion[76.9%(20/26 cases) vs.34.5%(10/29 cases)], co-infection[53.8%(14/26 cases) vs.24.1%(7/29 cases)], cyanotic congenital heart disease [84.6%(22/26 cases) vs.34.5%(10/29 cases)] and puncture difficulty[69.2%(18/26 cases) vs.17.2%(5/29 cases)] were statistically significant(all P<0.05). Logistic regression analysis showed postoperative VVR score ( OR=0.88, 95% CI: 0.77-0.99, P=0.04), blood lactate peak within 24 hours after surgery ( OR=6.62, 95% CI: 1.35-32.46, P=0.02), and cyanotic congenital heart disease ( OR=0.04, 95% CI: 0.00-0.63, P=0.04) were risk factors for venous thrombosis in the lower extremities. Conclusions:High postoperative VVR score, high 24 h blood lactate peak after surgery and cyanotic congenital heart disease are high risk factors for puncture- or catheter-related lower extremity venous thrombosis after surgery for CHD.
