新生儿复杂先心病急诊手术及死亡原因分析  

Emergency surgical treatment and mortality analysis for neonatal complex congenital heart disease

作　　者：仇黎生[1] 苏肇伉[1] 刘锦纷[1] 徐志伟[1] 徐卓明[1] 陈虹[1] 

机构地区：[1]上海交通大学医学院新华医院上海儿童医学中心心胸外科,上海200127

出　　处：《上海交通大学学报（医学版）》2007年第7期847-849,共3页Journal of Shanghai Jiao tong University:Medical Science

摘　　要：目的分析各类新生儿复杂先心病的急诊手术过程,总结新生儿心脏手术的围术期治疗经验,并分析死亡原因。方法对2003年1月～2005年12月施行的104例新生儿复杂先心病急诊手术的临床资料进行回顾性分析。结果共有9例患儿死亡,死亡率8.6%。生存者均无神经系统并发症。D-TGA延期关胸伤口感染2例,伤口愈合不良3例。心内型TAPVD术后因残余肺静脉回流梗阻再手术1例。结论及时诊断与手术是新生儿复杂先心病治疗成功的关键。合理的手术方法、优化的体外循环方案以及精细的术后监护,将提高新生儿复杂先心病患者的存活率。Objective To review and summarize the experience of perioperative treatment for neonatal complex congenital heart disease by analysing the course of emergency management and the cause of death. Methods The clinical data of 104 neonates with complex congenital heart disease who were performed emergency surgical treatment from Jan 2003 to Dec 2005 in our hospital were retrospectively analysed. Results There were 9 cases of death with a mortality rate of 8.6%. No postoperative neurological complications were observed in any patients survived. Wound infection and poor wound healing occured in 2 and 3 D-TGA patients with delayed sternal clousure, respectively. One patient with TAPVD was performed reoperation because of pulmonary vein obstruction. Conclusion Timely diagnosis and emergency surgical treatment are the key points for better prognosis. Fine operative technique, optimized cardiopulmonary bypass and intensive postoperative care may increase the survival for neonates with complex congenital heart disease.

关 键 词：新生儿 心脏病 先天性 复杂型 手术治疗 

分 类 号：R722.1[医药卫生—儿科]