Neurodevelopmental Outcome Of Children With Congenital Heart Disease And Perioperative Risk Factor Analysis

Objective:An examination of the postoperative neurodevelopmental follow-up of children with congenital heart disease,and an examination of the perioperative risk factors influencing neurodevelopmental status,is to be conducted.Method:A total of 110 children who underwent cardiopulmonary bypass surgery in our hospital were studied and divided into simple congenital heart disease group and complex congenital heart disease group according to the RACHS-1 risk scale.The Griffith Developmental Assessment Scale Chinese version was used to assess the development of these children.Multiple linear regression method was used to analyze the relationship between risk factors and neurodevelopmental lag,and ROC curve was used to predict the value of perioperative risk factors for developmental lag.The monitoring measures:weight at the time of surgery,age at the time of surgery,preterm birth,duration of aortic occlusion,duration of extracorporeal circulation,and duration of stay in the care unit after surgery.Blood test indicators:preoperative albumin,platelet,creatinine,hemoglobin,postoperative lactic acid levels.Neurodevelopmental follow-up:The Chinese version of Griffith Developmental Assessment Scale was used to evaluate the children with congenital heart disease after surgery,and the naked values in the fields of motor,private-social,language,hand-eye coordination and operation were calculated.Then,according to the Griffith Development Scale China Norm Book,the percentile in the field of movement,the percentile in the field of individual-social,the percentile in the field of language,the percentile in the field of handeye coordination,and the percentile in the field of performance were obtained.The backward level in all fields is less than 16%,and the backward level in one field indicates that there is a backward neurological development in children.Result:Children with complex congenital heart disease lag behind those with simple congenital heart disease in motor,individual-social,language,hand-eye coordination and performance after surgery.The weight at the time of surgery,the duration of extracorporeal circulation and the time in the care unit after surgery are correlated with the developmental lag in children with congenital heart disease.That is,the smaller the weight,the longer the duration of extracorporeal circulation and the longer the time in the care unit after surgery,the more likely the children are to have neurodevelopmental lag.ROC curve analysis indicated that surgical weight(AUC=0.804),duration of extracorporeal circulation(AUC=0.829)and duration of postoperative stay in the ICU(AUC=0.787)were of greater value in predicting neurodevelopmental delay in children with congenital heart disease.There was a correlation between the duration of extracorporeal circulation during operation and the neurodevelopmental lag in children with complex congenital heart disease after surgery.The longer CPB duration was of great value in predicting the neurodevelopmental lag in children with complex congenital heart disease after surgery(AUC=0.819).Conclusion:Compared with the simple congenital heart disease group,the children with complex congenital heart disease showed significant neurodevelopmental lag,which was manifested as the lag in motor,individual-social,language,hand-eye coordination,and performance.There is a correlation between the duration of extracorporeal circulation(CPB)and the neurodevelopmental lag in children with complex congenital heart disease.The longer CPB duration is of great value in predicting the neurodevelopmental lag in children with complex congenital heart disease.