Made available in DSpace on 2015-04-14T13:33:01Z (GMT). No. of bitstreams: 1 443948.pdf: 769828 bytes, checksum: 9cf0dde32ae45c3c2ac9b4e8c917f9b7 (MD5) Previous issue date: 2012-08-27 / Introduction: Because it is an invasive procedure in a vital organ, the heart, cardiac surgery is a high-risk surgery. And the pediatric surgeries in turn, assume a more delicate situation because they deal with complex congenital heart disease in patients with a very small anatomy and proportional to their body surface. Objective: To determine the epidemiological profile of patients that have undergone congenital heart surgery, treated at the Hospital of PUCRS. Methods: This research can be characterized as a cross-sectional study of quantitative history. The study included patients aged 29 days to 18 years old. Sample of 162 children who underwent pediatric congenital cardiac surgery in this institution. To better analyze the surgical complications they are divided into five groups: cyanotic with reduced blood flow, with antegrade cyanotic, acyanotic without overflow, acyanotic with antegrade, Extra-cardiac. Divided into 3 groups for better classification We conducted a review of electronic medical records service and the entire sample was identified through information contained in these files and the information was supplemented by data from the Medical Service, and Statistics (SAME). Data were collected through procedures that occurred from January 2007 to December 2011. The study included patients aged from 29 days to 18 years old. The data were analyzed with SPSS System, Study approved by the Ethics Committee. Results: There was a predominance of females, 51.2%, average age 52.45 months, 82.1% for SUS patients, mortality of 11.7%, 94.4% elective surgery and 69, 1% underwent surgery with extracorporeal circulation (ECC). Conclusion: A greater number of surgery at the age of 29 days to 5 years, without gender predominance, higher incidence of acyanotic heart disease with increased blood flow with a predominance of atrial septal defects (ASDs). Most patients were SUS. It was observed that the service returned to elective surgeries, with a low incidence of emergency care. / Introdu??o: A cirurgia card?aca, por se tratar de um procedimento invasivo em um ?rg?o vital, o cora??o, ? uma cirurgia de alto risco. As cirurgias pedi?tricas por sua vez, assumem uma situa??o mais delicada por serem cardiopatias complexas em pacientes com uma anatomia muito diminuta e proporcional a sua superf?cie corp?rea. Objetivo: Determinar o perfil epidemiol?gico dos pacientes com cardiopatias cong?nitas cir?rgicas, atendidos no Hospital S?o Lucas da PUCRS. M?todos: A presente investiga??o pode ser caracterizada como um estudo de corte transversal hist?rico quantitativo. Foram inclu?dos no estudo pacientes com idade de 29 dias a 18 anos incompletos. A amostra foi de 162 crian?as que foram submetidas ? cirurgia card?aca cong?nita pedi?trica nesta institui??o. Para uma melhor an?lise, as patologias cir?rgicas est?o divididas em cinco grupos: Cian?ticas com hipofluxo, Cian?ticas com hiperfluxo, Acian?ticas sem hiperfluxo, Acian?ticas com hiperfluxo, Extra-card?acas. Divididos em 3 grupos et?rios para melhor classifica??o. Foi feita uma an?lise de prontu?rios eletr?nicos do servi?o e toda a amostra foi identificada atrav?s de informa??es contidas nestes prontu?rios, informa??es que foram complementadas atrav?s de dados do Servi?o de Atendimento M?dico e Estat?stica (SAME). Os dados foram coletados atrav?s de procedimentos que ocorreram no per?odo de janeiro de 2007 a dezembro de 2011. Os dados foram analisados no Sistema SPSS, Estudo aprovado pelo Comit? de ?tica. Resultados: Predom?nio do sexo feminino com 51,2%, m?dia de idade de 52,45 meses, 82,1% de pacientes atendidos pelo SUS, mortalidade de 11,7%, 94,4% de cirurgias eletivas e 69,1% foram submetidos a cirurgia com circula??o extracorp?rea (CEC). Conclus?o: Houve maior n?mero de cirurgias na faixa et?ria dos 29 dias aos 5 anos, sem predom?nio de sexo, maior incid?ncia de cardiopatia acian?tica com hiperfluxo, principalmente das comunica??es interatriais (CIAs). A maioria dos pacientes foram atendidos pelo SUS. Observou-se que o servi?o est? voltado para a realiza??o de cirurgias eletivas, com baixa incid?ncia de urg?ncias e emerg?ncias.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-03-31T22:08:52Z No. of bitstreams: 1 MarianaAlieviMari_DISSERT.pdf: 1381499 bytes, checksum: caa24d7f6c4061e0b064a8be511fd496 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-04-01T21:48:41Z (GMT) No. of bitstreams: 1 MarianaAlieviMari_DISSERT.pdf: 1381499 bytes, checksum: caa24d7f6c4061e0b064a8be511fd496 (MD5) / Made available in DSpace on 2016-04-01T21:48:41Z (GMT). No. of bitstreams: 1 MarianaAlieviMari_DISSERT.pdf: 1381499 bytes, checksum: caa24d7f6c4061e0b064a8be511fd496 (MD5) Previous issue date: 2015-04-27 / O desenvolvimento infantil ? o resultado da intera??o de fatores biol?gicos, psicol?gicos e sociais. Ambiente hostil, renda, est?mulos oferecidos, bem como a presen?a de uma doen?a cr?nica s?o quest?es que podem interferir significativamente. Considerando as doen?as cr?nicas, podemos identificar a cardiopatia cong?nita (CC) que se caracteriza por malforma??es card?acas anat?micas e funcionas e atualmente tem apresentado uma incid?ncia de at? 1% na popula??o de nascidos vivos. Esta pesquisa teve como objetivo avaliar o desenvolvimento infantil e verificar uma associa??o com o comprometimento por fatores biopsicossociais de crian?as com e sem CC. Fizeram parte do estudo crian?as de zero a seis anos, divididas em tr?s grupos: Grupo1- 29 crian?as cardiopatas cong?nitas pr?-cir?rgicas, Grupo2- 43 crian?as cardiopatas p?scir?rgicas e Grupo3- 56 crian?as saud?veis. Os instrumentos utilizados foram um question?rio biopsicossocial e o Teste de Triagem de Denver II. Do total de 128 crian?as avaliadas, 66 (51,56%) s?o meninas, sendo que a idade variou dos dois meses aos seis anos (mediana 24,5 meses). No G1 e G2 houve predom?nio de cardiopatias acian?ticas (55,2% e 58,1%). Em rela??o as avalia??es do Denver II, as crian?as cardiopatas tiveram mais classifica??es de desenvolvimento ?suspeito? e ?suspeito/anormal?, sendo que 41,9% das crian?as que j? passaram por procedimento cir?rgico tiveram seu desenvolvimento caracterizado como ?suspeito/anormal?. No grupo das crian?as saud?veis 53,6% foram classificadas com perfil desenvolvimental ?normal? (p=?0,0001). Sobre os dom?nios do Denver II, entre as crian?as cardiopatas houve maior altera??o nas ?reas motoras (p= 0,016, p=?0,001). As vari?veis biopsicossociais que se mostraram relacionadas a um poss?vel atraso no desenvolvimento foram: sexo (p=0,042), idade da crian?a (p=0,0001) e renda per capita (p=0,019). N?o foram encontradas associa??es entre as vari?veis relacionadas ao tratamento da cardiopatia, informa??o, compreens?o da doen?a e do modo como os pais tratam os filhos. J? no grupo das crian?as saud?veis evidenciou-se que crian?as que passaram por interna??o hospitalar tiveram mais ?ndices de altera??es no desenvolvimento (p=0,025) e quanto maior o n?mero de interna??es mais essas altera??es se intensificaram (p=0,023). Os resultados sugerem que crian?as com cardiopatia cong?nita tenham prov?vel atraso no desenvolvimento. Tamb?m foi poss?vel verificar que existe uma diferen?a significativa entre as crian?as que passaram por procedimento cir?rgico, daquelas que ainda aguardam cirurgia fazendo somente acompanhamento cl?nico. As altera??es de o desenvolvimento estarem mais ligadas as ?reas motoras podem ser explicadas por aspectos caracter?sticos da doen?a e do tratamento, como dispneia, cansa?o, cuidados e limita??es nas atividades di?rias. As vari?veis sexo e idade parecem ser determinantes no desenvolvimento, bem como, crian?as saud?veis passarem por experi?ncia de hospitaliza??o. J? nas crian?as cardiopatas, se percebeu que as vari?veis sociais que envolvem a doen?a e o tratamento n?o comprometeram o desenvolvimento. Essa quest?o pode ser entendida por meio de fatores protetores e de resili?ncia, j? que essa popula??o recebe apoio familiar e social. / Child development is the result of the interaction of biological, psychological and social factors. Hostile environment, income, offered stimuli, as well as the presence of a chronic illness are issues that may interfere significantly. Considering the chronic diseases, we can identify congenital heart disease (CHD) is characterized by anatomical heart defects and functional and currently has presented an incidence of up to 1% of the population of live births. This research aimed to evaluate child development and verify an association with the commitment by biopsychosocial factors of children with and without CHD. Study participants were children from zero to six years, divided into three groups: Group1- 29 children pre-surgical congenital heart disease, Group2- 43 children post-surgical cardiac patients and Group3- 56 healthy children. The instruments used were a biopsychosocial questionnaire and the Screening Test Denver II. Of the total of 128 children evaluated, 66 (51.56%) are girls, and ages ranged from two months to six years (median 24.5 months). In G1 and G2 predominated acyanotic heart disease (55.2% and 58.1%). Regarding the Denver II reviews, children with heart disease had more development ratings "suspicious" and "suspect/abnormal", and 41.9% of children who have gone through surgery had characterized its development as "suspect/abnormal" . In the group of healthy children 53.6% were classified as developmental profile "normal" (p = ?0,0001). On the areas of Denver II, among children with heart disease was greatest change in motor areas (p = 0.016, p = ?0,001). The biopsychosocial variables that were related to a possible developmental delay were gender (p = 0.042), child's age (p = 0.0001) and income per capita (p = 0.019). There were no associations between the variables related to the treatment of disease, information, understanding of the disease and the way parents treat their children. In the group of healthy children showed that children who underwent hospitalization rates were more changes in development (p = 0.025) and the higher the number of admissions over these changes have intensified (p = 0.023). The results suggest that children with congenital heart disease have likely delayed development. It was also observed that there is a significant difference between the children who have gone through surgery, those who are still waiting for surgery only doing clinical follow-up. Changes in the development are more connected motor areas can be explained by the characteristic features of the disease and treatment, such as dyspnea, fatigue, care and limitations in daily activities. The gender and age appear to be decisive in the development as well as healthy children go through hospitalization experience. Already in children with heart disease, it was realized that social variables involved in the disease and the treatment did not affect the development. This question can be understood by means of protective factors and resiliency, as this population receives family and social support.