10公斤以下低体重婴幼儿先天性心脏病的外科治疗  

Surgical treatment of congenital heart diseases in pediatric patients with body weight less than 10 kg

作　　者：姚建民[1] 赵向东[1] 肖志斌[1] 卢宁[1] 陆龙[1] 庞中一[1] 王东文[1] 崔振田[1] 刘静[1] 

机构地区：[1]北京军区总医院心血管病中心外科,北京100700

出　　处：《中国当代儿科杂志》2008年第5期596-598,共3页Chinese Journal of Contemporary Pediatrics

摘　　要：目的探讨10kg以下低体重婴幼儿先天性心脏病的外科治疗问题。方法自2000年1月至2007年12月,外科治疗10kg以下低体重婴幼儿先天性心脏病105例,体重3.5～10kg,年龄2个月至3岁,其中合并中度以上肺动脉高压和/或反复肺部感染史56例,复杂先天性心脏病35例。中度低温体外循环下手术88例,常温非体外循环心脏跳动下手术14例,深低温停循环选择性脑保护下手术3例;根治手术101例,姑息性手术4例。结果住院死亡5例(4.8%),存活100例,随访2月至3年,根治手术的97例中,室间隔缺损少量残余分流2例,无其他并发症和死亡,均生长发育良好,心功能I级;姑息手术的3例症状明显减轻。结论随着围术期管理、麻醉、体外循环和外科技术的提高,10kg以下低体重婴幼儿先天性心脏病外科治疗是安全的,临床效果良好。Objective To report the experience of the surgical treatment of congenital heart diseases （CHD） in pediatric patients with body weight less than 10 kg. Methods Between January 2000 and December 2007, 105 children with CHD, aged 2 months to 3 years and weighing between 3.5 to 10 kg, underwent surgical treatment. Of the 105 patients, 56 were concomitant with moderate to severe pulmonary hypertension or repeated pulmonary infections, and 35 with complex cardiac abnormalities. Operations were performed through median sternotomy with moderate hypothermic cardiopulmonary bypass in 88 cases, with normothermic extracorporeal circulation on beating heart in 14 cases, and with deep hypothermic circulatory arrest in 3 cases. Results There were 5 early deaths （4.8%）. During a follow-up of 2 month to 3 year, 97 survivors with corrective procedure had no late mortality or complications with NYHA class 1 of cardiac function, excepting 2 cases with little residual shunt. Three survivors with palliative procedure enjoyed higher quality of life. Conclusions The surgical treatment of CHD in pediatric patients with body weight less than 10 kg seems to be feasible and safe, with satisfactory early and long-term results.

关 键 词：先天性心脏病 心脏外科 低体重 儿童 

分 类 号：R726.5[医药卫生—儿科]