这项研究旨在确定影响经胸球囊扩张肺动脉瓣治疗的肺动脉瓣闭锁和完整室间隔患儿预后的因素。该研究包括148名参与者,他们接受了5年的随访。其中,10人死亡,138人活了下来。采用独立样本t检验和χ2检验对死亡组和存活组患儿的临床资料进行分析。发现那个高度,体重,体表面积,动脉血氧饱和度,三尖瓣反流程度,肺动脉瓣交叉瓣压差,ICU住院时间,逗留时间,再手术干预,与并发症比较差异有统计学意义(P<0.05)。ROC曲线分析各测量指标差异有统计学意义,体重,体表面积,动脉血氧饱和度,ICU住院时间,住院时间的AUC范围为0.723至0.870。Logistic回归分析显示三尖瓣反流程度,肺动脉瓣交叉瓣膜压差,ICU住院时间,再手术干预,及并发症是影响经胸肺动脉瓣球囊扩张术患者预后的独立危险因素。该研究提出了使用R语言软件4.0“rms”软件包的列线图预测模型,使用校准曲线和决策曲线进行验证。该模型的C指数为0.667(95%CI:0.643-0.786),拟合程度高。这项研究为临床医生提供了一个预测模型,以识别经肺瓣膜球囊扩张治疗后预后不良的儿童。.
This study aimed to identify factors that affect the prognosis of children with pulmonary valve atresia and intact ventricular septum treated with transthoracic balloon dilation of the pulmonary valve. The study included 148 participants who were followed up for 5 years. Of these, 10 died, while 138 survived. Independent sample t-test and χ2 test were used to analyze clinical data of children in the death and survival groups. It was found that height, weight, body surface area, arterial oxygen saturation, degree of tricuspid regurgitation, pulmonary valve cross valve pressure difference, ICU length of stay, length of stay, reoperation intervention, and complications were statistically significant (P<0.05). ROC curve analysis of the measurement indicators with statistically significant differences showed that height, weight, body surface area, arterial oxygen saturation, ICU length of stay, and length of stay had AUCs ranging from 0.723 to 0.870. Logistic regression analysis revealed that the degree of tricuspid regurgitation, pulmonary valve cross valvular pressure difference, ICU length of stay, reoperation intervention, and complications were independent risk factors that affect the prognosis of patients with PA/IVS undergoing transthoracic balloon dilation of pulmonary valve. The study proposed a nomogram prediction model using R language software 4.0 \"rms\" package, which was validated using calibration curve and decision curve. The model had a C-index of 0.667 (95% CI: 0.643-0.786) and high degree of fit. This study provides clinicians with a prediction model to identify children with poor prognosis after treatment with transpulmonary valve balloon dilatation. .