危重婴儿先天性心脏病围手术期应对策略  

Strategy for critical and complex congenital heart disease in infants during perioperation

作　　者：林薇[1] 谈凌凌[1] 王哲[1] 龚琪[1] 徐振海[1] 

机构地区：[1]河北医科大学第四医院胸心外科,石家庄市050011

出　　处：《中华实用诊断与治疗杂志》2008年第11期804-806,共3页Journal of Chinese Practical Diagnosis and Therapy

基　　金：2007年河北省科技支持计划项目(编号072761997)

摘　　要：目的:探讨危重婴儿先天性心脏病围手术期应对策略。方法:138例危重先天性心脏病婴儿施行外科手术,18例动脉导管未闭在非体外循环下行单纯结扎,120例在体外循环下行心脏大血管畸形解剖矫治。结果:术后呼吸机辅助时间2～112h,平均(35.2±16.3)h,ICU时间2～7d,平均(4.2±1.8)d,全组住院死亡8例,病死率5.8%(8/138),其余术后并发症为低心输出量综合征12例,肺不张5例,肺部感染9例,均治愈,随访1～24个月,无晚期死亡,心功能Ⅰ～Ⅱ级。结论:危重婴儿先天性心脏病外科手术恰当的围手术期综合处理是手术成功的保证,可挽救多数患儿生命,并取得良好效果。Objective To study the feasibility, indication, technique of operation and the perioperation management on critical and complex congenital heart disease in infants. Methods One hundred and thirty-eight infants with critical and complex congenital heart disease received operation, in which 18 received patent ductus arteriosus without cardiopulmonary bypass, the other 120 cases were operated with cardiopulmonary bypass. Results The lasting time of intubation was from 2 to 112 hours, averagely （35.2±16.3） hours and ICU staying time was form 2 to 7 days, averagely （4.2± 1.8）days. The operative mortality was 5. 8% （8/138）. The postoperative complications in other infants included 12 cases of low cardiac output syndrome, 5 of atelectasis, and 9 of lung infection. All were followed up from 1 to 24 months. The cardiac function was from class Ⅰto Ⅱ/Ⅲ. The operative result was satisfactory. Conclusion The proper perioperation management is important for critical and complex congenital heart disease in infants, and can save most of their lives. The good result can be obtained from surgical treatment.

关 键 词：复杂先天性心脏病 婴儿 围手术期 

分 类 号：R726.5[医药卫生—儿科]