rospedРоссийский педиатрический журнал имени М.Я. СтуденикинаM.Ya. Studenikin Russian Pediatric JournalФГАУ «НМИЦ здоровья детей» Минздрава России10.46563/1560-9561-2024-27-1-40-43ypeyhkrosped-531Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL INVESTIGATIONSЭкстракардиальная патология как дополнительный фактор риска при коррекции врождённых пороков сердца у детейExtracardial pathology as an additional risk factor in the correction of congenital heart defects in childrenhttps://orcid.org/0000-0002-7512-3991СарсенбаеваГульжан ИскендировнаSarsenbaevaGulzhan I.

Канд. мед. наук, кардиохирург, АО «Научный центр педиатрии и детской хирургии» Минздрава Республики Казахстан

e-mail: gulzhan75@mail.ru

MD, PhD, cardiac surgeon, Scientific Center of Pediatrics and Pediatric Surgery, Almaty, 050044, Republic of Kazakhstan

e-mail: gulzhan75@mail.ru

gulzhan75@mail.ruАО «Научный центр педиатрии и детской хирургии» Минздрава Республики КазахстанScientific Center of Pediatrics and Pediatric Surgery2024040420242714043Copyright © Сарсенбаева Г.И., 20242024Сарсенбаева Г.И.Sarsenbaeva G.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rosped.ru/jour/article/view/531Введение

Введение. Сопутствующие заболевания при коррекции врождённых пороков сердца (ВПС) у детей являются значимыми факторами риска развития осложнений в послеоперационном периоде и актуальной проблемой детской кардиохирургии. В статье представлена роль коморбидности в детской кардиохирургии. Проведён сравнительный анализ клинических показателей кардиохирургического лечения пациентов с экстракардиальной патологией и без таковой.

Цель

Цель: определить значение экстракардиальной патологии как дополнительного фактора риска при коррекции ВПС у детей.

Материалы и методы

Материалы и методы. Проведён проспективный анализ 500 кардиохирургических пациентов, госпитализированных в отделение кардиохирургии и интервенционной кардиологии. Пациенты были распределены на группы с сопутствующей патологией (n = 350) и без сопутствующих болезней (n = 150). Использованы комплекс современных лечебных и диагностических процедур, мультидисциплинарный анализ.

Результаты

Результаты. Установлена высокая частота развития осложнений у больных основной группы (70%). Госпитальная летальность была увеличена у пациентов с сопутствующей патологией и составила 17,4% по сравнению с больными без сопутствующей патологии (3,3%). Средняя продолжительность пребывания в отделении реанимации и интенсивной терапии у пациентов с сопутствующей патологией составила 18 ± 2 койко-дня, у пациентов без сопутствующей патологии — 4 ± 2.

Заключение

Заключение. Наличие сопутствующей патологии у детей с ВПС существенно влияет на формирование осложнений и является прогностическим фактором риска, который необходимо включать в современные модели прогнозирования.

Финансирование

Финансирование. Исследование не имело финансовой поддержки.

Конфликт интересов

Конфликт интересов. Автор заявляет об отсутствии конфликта интересов.

Поступила 08

Поступила 08.12.2023Принята к печати 30.01.2024Опубликована 28.02.2024

Introduction

Introduction. Concomitant diseases as a risk factor for surgery remain an urgent problem in pediatric cardiac surgery. The article presents the role of comorbidity in pediatric cardiac surgery. A comparative analysis of the indicators of cardiac surgical treatment of patients with and without extracardiac pathology was carried out. Aim: to determine the significance of extracardiac causes as an additional risk factor in the correction of congenital heart lesions in children.

Materials and methods

Materials and methods. Prospective analysis of five hundred patients who had undergone cardiac surgery in the departments of cardiac surgery and interventional cardiology. Patients were divided into a main group of patients with concomitant pathology (n = 350) and a control group (n = 150) without concomitant pathology. A complex of modern therapeutic and diagnostic procedures and a multidisciplinary approach were used.

Results

Results. A high incidence of complications was shown in the main group (70%). Hospital mortality was higher in patients with concomitant pathology and amounted to 17.4%, compared to 3.3% in the group without concomitant pathology. The average duration in the ICU for patients with concomitant pathology was 18 ± 2 bed days, for patients without concomitant pathology — 4 ± 2 bed days.

Conclusion

Conclusion. The presence of concomitant pathology has been shown to influence significantly on the development of complications and be a prognostic risk factor that must be included in modern prediction models.

Acknowledgment

Acknowledgment. The study had no sponsorship.

Conflict of interest

Conflict of interest. The author declares no conflict of interest.

Received

Received: December 08, 2023Accepted: January 30, 2024Published: February 28, 2024

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The authors declare that there are no conflicts of interest present.