Objective: To investigate the inplementation of cardiovascular surgery for congenital heart disease (CHD) in China. Methods: A cross-sectional study was carried out. The CHD cardiovascular surgery data collected by the Chinese Society of Extracorporeal Circulation from 2017 to 2021 in 31 provinces (autonomous regions/municipalities) of China were retrospectively reviewed, the implementation of CHD cardiovascular surgery in different provinces, regions, general/specialized hospitals, and different age groups (whether≤18 years old) were summarized, and the correlation analysis between the number of surgeries carried out in each province/region and the gross regional product and the number of the regional population was performed. Results: Between 2017 and 2021, the annual volume of CHD cardiovascular surgery was 77 120, 77 634, 81 161, 62 663 and 71 492, respectively, showing a decreasing trend. Meanwhile, the proportion of CHD patients aged≤18 years who underwent cardiovascular surgery also showed a downward trend, from 79.8% (61 557/77 120) in 2017 to 58.6% (41 871/71 492) in 2021 (P=0.027). The number of surgical cases varied greatly among different provinces, including 4 provinces with≥5 000 cases and 9 provinces with 2 000-5 000 cases. In the five years, the number of CHD cardiovascular surgeries in Central and East China was the largest, accounting for 41.1%-45.5% of the total surgical cases. The proportion of CHD surgery cases≤18 years old was the highest in Southwest China (69.7%-87.4%) and the lowest in Northeast China (28.2%-68.9%). Except for 2021, the number of cases carried out by each region between 2017 and 2020 was correlated with the gross regional product (r=0.929, 0.929, 0.893 and 0.964, respectively, all P<0.05) and the population (r=0.821, 0.893, 0.821 and 0.857, respectively, all P<0.05). Hospitals that performed more than 100 operations (20.5%±1.2% of the total number of hospitals) completed 86.2%±1.2% of the total number of operations in China during the 5-year period. In 2017 and 2021, the number of CHD cardiovascular surgeries preformed in children's/women's and children's specialized hospitals accounted for 24.3% (18 772/77 120) and 23.8% (17 012/71 492) of the total number of cases in China, respectively. Conclusions: From 2017 to 2021, the number of cardiovascular surgery for CHD decreases slightly, but the proportion of surgery for adult CHD patients increases significantly.There is a strong correlation between the number of CHD operations in each region and their economic development status. The scale of CHD cardiovascular surgery performed in children's hospitals/women's and children's hospitals accounts for about a quarter of the total volume in China.
目的： 调查2017—2021年我国先天性心脏病（CHD）外科手术开展情况。 方法： 该研究为现况调查。基于中国生物医学工程学会体外循环分会收集整理的2017—2021年我国31个省（自治区、直辖市）CHD外科手术数据资料，总结各省/区域、综合/专科医院、不同年龄（是否≤18岁）的CHD外科手术开展情况，并分析各省/区域的开展例数与地区生产总值、地区人口数量之间的相关性。 结果： 2017—2021年，我国31个省（自治区、直辖市）CHD心血管外科年手术量依次为77 120、77 634、81 161、62 663及71 492例，总体呈下降趋势；≤18岁的CHD外科手术占比也呈下降趋势，从2017年的79.8%（61 557/77 120）降至2021年的58.6%（41 871/71 492）（P=0.027）；各省份之间的手术例数差别较大，其中≥5 000例有4个省份，2 000~5 000例有9个省份；5年期间，华中及华东地区的CHD外科手术例数最多，占总例数的41.1%~45.5%。≤18岁CHD手术例数占比最高的为西南地区（69.7%~87.4%），占比较低的为东北地区（28.2%~68.9%）。除2021年外，2017—2020年各区域开展例数与其当年的地区生产总值（r值分别为0.929、0.929、0.893、0.964，均P<0.05）及人口数量（r值分别为0.821、0.893、0.821、0.857，均P<0.05）呈高度正相关；5年期间，年开展例数在100例以上（医院数量占比为20.5%±1.2%）的医院完成了86.2%±1.2%的手术量。2017及2021年儿童/妇幼专科医院开展CHD外科手术例数分别占总例数的24.3%（18 772/77 120）及23.8%（17 012/71 492）。 结论： 2017—2021年，我国CHD外科手术例数略有下降，其中成人CHD患者手术占比增高。各地区开展CHD手术例数与当地经济发展状况的相关性较强。儿童/妇幼医院年开展CHD外科手术例数约占全国总例数的1/4。.