婴幼儿先天性心脏病的外科手术与围术期处理  

Surgical and perioperative management of congenital heart disease in infants

作　　者：蓝斌[1] 蔡志雄[2] 林明祥[3] 陈恕[1] 马陈声[1] 郑慧[4] 黄小萌[4] 高舜英[1] 李木泉[1] 李锐雄[1] 

机构地区：[1]汕头市中心医院心胸外科,广东省汕头市515031 [2]汕头市中心医院心内科,广东省汕头市515031 [3]汕头市中心医院小儿科,广东省汕头市515031 [4]汕头市中心医院麻醉科,广东省汕头市515031

出　　处：《中国心血管病研究》2005年第12期893-895,共3页Chinese Journal of Cardiovascular Research

基　　金：广东省医学科学研究基金项目资助(编号:A2004641)

摘　　要：目的总结婴幼儿先天性心脏病的外科手术经验。方法自2000年1月至2004年12月共为133例,年龄5￣36个月,体重6￣15kg的先天性心脏病患儿施行外科手术治疗。全组非体外循环动脉导管结扎术29例;体外循环手术104例,包括室间隔缺损、继发孔房间隔缺损、肺动脉瓣狭窄、部分型房室间隔缺损、部分型肺静脉异位引流、法乐四联症、房间隔缺损并右室流出道梗阻和其他复合畸形。结果全组术后住院死亡6例,死亡率4.5%。术后主要并发症包括低心排综合征、呼吸衰竭、心律失常、肺部感染、出血等。死亡原因包括重度低心排综合征、严重室性心律失常、肺动脉高压危象等。结论心外科、心儿科、麻醉科等人员的密切配合,心内、外科镶嵌治疗成为婴幼儿心脏外科手术成功的重要保证。Objective To summarize experiences of surgical correction and perioperative management of congenital heart disease in infants. Methods From January 2000 to December 2004, 133 cases of infants, aged 5-36 months old （6-15 kg）, with congenital heart defects, including patent ductus arteriosus , ventricular septal defect, atrial septal defeet, pulmonary valve stenosis , partial atrial ventricular septal defect, partial abnormal pulmonary venous drainage, tetralogy of Fallot, atrial septal defect and right ventricular outflow tract obstruction et al, undergone cardiac defect corrections in this hospital. Results The perioperative mortality was 4.5%（6/133）. The most common post-operative complications were low cardiac output syndrome , respiratory failure , arrhythmia , pulmonary infection ,and hemorrhage. The causes leading to death included serious low cardiac output syndrome, serious ventricular arrhythmia, worsened pulmonary hypertension. Conclusion It is relatively safe to correct the congenital heart defects in the very early time of life.

关 键 词：心脏病/先天性 儿童 学龄前 外科手术 选择性 围手术期医护 

分 类 号：R654.2[医药卫生—外科学]