目的:检查先天性心脏病(CHD)患儿体外循环(CPB)术后早期癫痫发作的情况，并探讨影响癫痫发作的因素。方法:纳入2018年5月至2019年4月入心脏重症监护室(CICU)的87例CPB术后患儿(年龄3 d～110个月，中位年龄4.4个月)，77例在术后72 h内行持续脑电图(EEG)及脑氧饱和度(ScOn 2)监测，10例转出CICU后发生临床癫痫，再次转入行8～180 h的EEG监测。每4 h记录临床数据，包括血压、中心静脉压(CVP)、体温、动脉血气、乳酸、多巴胺、米力农、肾上腺素剂量，每天测量C反应蛋白(CRP)及前体脑钠肽(NT-proBNP)。记录人口数据、CHD外科手术复杂程度等级(STAT)及临床结局指标(机械通气、CICU停留、住院时间及是否死亡)。n 结果:24例(27.6%)患儿出现癫痫发作，首次发作均于48 h内，其中7例为临床伴EEG发作，7例为脑电图发作，10例为临床发作，3例转归为癫痫，2例死亡并均有脑电图癫痫发作。癫痫组较无癫痫组手术时间更长、STAT分级更高、临床结局更差(均n P<0.05)。单因素回归分析中，癫痫发作与肾上腺素剂量、体温、乳酸水平(均n P<0.01)、血压、CVP(均n P<0.05)及CRP(n P<0.1)均呈正相关，与动脉血二氧化碳分压[n pa(COn 2)]、ScOn 2、米力农剂量呈负相关(均n P<0.05)。多因素回归分析中，癫痫发作与肾上腺素剂量(n P<0.001)、乳酸水平(n P<0.01)呈正相关。n 结论:此队列术后早期癫痫发作发生率较高。与癫痫发作相关的围术期因素有许多，其中最显著的危险因素是肾上腺素高剂量和乳酸升高。在我国，CPB后脑损伤亟需得到重视，以减轻并改善神经发育结局。“,”Objective:To examine the occurrence of seizures and perioperative risk factors in children after obtaining cardiopulmonary bypass (CPB).Methods:Electroencephalograph (EEG) and cerebral oxygen saturation (ScOn 2) were monitored in 87 patients (aged 3 days-110 months, with the median at 4.4 months) and they were admitted to the Cardiac Intensive Care Unit (CICU) from May 2018 to April 2019, with 77 patients for 72 h after CPB and 10 cases with clinical seizures after CICU discharge for 8-180 h. Clinical data were recorded every 4 hours, including blood pressure, central venous pressure (CVP), temperature, arterial blood gases, lactate, doses of Dopamine, Milrinone, and Adrenalin, and daily C-reaction protein (CRP) and N-terminal pro-brain natriuretic peptide(NT-proBNP). Demographic data, the Society of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery(STAT) mortality classification and clinical outcomes (duration of mechanical ventilation, CICU and hospital stay, and death) were recorded.n Results:Seizures occurred in 24 patients (27.6%) within 48 h after CPB.EEG seizures appeared in 7 patients, both EEG and clinical seizures in 7 patients, and clinical seizures in 10 patients.Three patients developed epilepsy.There were 2 hospital deaths and both had EEG seizures.Patients with seizures had higher STAT categories, longer operative time and worse clinical outcomes (all n P<0.05). Univariate regression revealed that the occurrence of seizures was positively related to adrenalin, temperature, lactate level (alln P<0.01), blood pressure, CVP (alln P<0.05) and CRP (n P<0.1), and negatively correlated with arterial carbon dioxide tension[n pa(COn 2)], ScOn 2 and dose of Milrinone (all n P<0.05). In multivariate regression, only dose of Adrenalin (n P<0.001) and lactate level (n P<0.01) remained significant.n Conclusions:The incidence of seizures was high in children after CPB.Numerous perioperative factors that were related to seizures were identified.The most significant risk factors were higher dose of adrenaline and lactate level.Studies on neurological injury after CPB are urgently needed in China in order to reduce brain injury and improve neurodevelopmental outcomes.