低体重小儿先天性心脏病矫治术的麻醉管理  

Cardiac anesthesia control in infants with weight

作　　者：王洪[1] 徐洪珍[1] 彭明清[1] 叶茂[1] 

机构地区：[1]重庆医科大学附属儿童医院麻醉科,重庆400014

出　　处：《重庆医科大学学报》2006年第6期889-891,共3页Journal of Chongqing Medical University

摘　　要：目的:总结43例低体重(≤5kg)小儿先天性心脏病矫治术的麻醉管理,并对心肌保护、脑保护进行探讨。方法:常规麻醉诱导,气管插管,动静脉穿刺,体外循环,根据需要维持全身深、中、浅低温;主动脉开放后用血管活性药物维持血流动力学。结果:2例大动脉转位患儿死于吻合口渗漏,1例法乐氏四联症患儿死于低心排综合征,肺部并发症8例,Ⅲ度房室传导阻滞1例,其余患儿均恢复良好。本组患儿死亡率6.98%。结论:低体重小儿先天性心脏病矫治术的麻醉管理较困难,死亡率高,并发症多,但只要处理得当,可降低其死亡率及并发症。Objective：To summarize the anesthesia experience of open heart surgery in 43 infants （weigh less than 5kg） and to explore the related issues with myocardioprotection and brain protection. Methods：Conventional induction of anesthesia , nasotracheal intubation, arteriovenous puncture, cardiopulmonary bypass were established, according to the needs for maintaining the body low temperature （deep, middle, superficial ） ; haemodynamics was maintained with vasoactive agent after aorta was opened. Results： Two infants with transposition of conducting arteries succumbed to stoma leak.One infant with tetralogy of Fallot succumbed to low cardiac output syndrome,bellows complication appeared in 8 cases, Ⅲ. atrial ventricular block 1, and the rest infants recovered well. Mortality was 6.98 % in this group.Conclusion：Cardiac anesthesia control in infants with low weight is diffficuh,death rate is hiqh and complication is complex.Butas long as control is done well, mortality omd complitation can be devreased.

关 键 词：低体重 先天性心脏病 麻醉管理 

分 类 号：R614.27[医药卫生—麻醉学]