婴幼儿主动脉弓中断及合并畸形一期矫治术的麻醉管理  

Anesthetic management of primary corrective aortic surgery in infant with interrupted arch associated with malformation

作　　者：鞠吉峰[1] 乔彬[1] 吴莉莉[1] 高毅[1] 蒋怡燕[1] 徐军[1] 林晓娜[1] 

机构地区：[1]济南军区总医院心血管病研究所,山东济南250022

出　　处：《实用医药杂志》2012年第1期5-7,共3页Practical Journal of Medicine & Pharmacy

摘　　要：目的探讨婴幼儿主动脉弓中断及合并畸形一期矫治术的麻醉处理特点。方法 23例主动脉弓中断及合并畸形婴幼儿行一期矫治术,全组患者均在深低温停循环下进行,采用常规超滤及改良超滤,入室至深低温停循环前均以前列腺素E1(PGE1)10～30 ng/kg.min输注。结果转流时间为(87±72)min,阻断主动脉时间为(67±42)min,深低温停循环时间(45±23)min。停机后下肢动脉压力超过上肢11例,与上肢相同8例,低于上肢4例。无麻醉并发症。19例痊愈出院,恢复良好。结论适当的术中麻醉管理有助于手术成功进行与患者术后恢复。Objective To evaluate the anesthetic management of primary corrective surgery in infant with interrupted aortic arch associated with malformation. Methods Corrective surgery was performed in twenty three infant with interrupted aortic arch associated with malformations under deep low temperature and circulation arrest after general anesthesia. And routine hyperfihration or modified hyperiihration was adopted before the end of cardiopulmonary bypass; （PGE1）10-30 ng/kg.min injecting was kept before deep low temperature and circulation arrest. Results Bypass time was （87±72）min,the aortic obstruction time was （67±42）min,and the circulation arrest time was （45±23）min; blood pressure of lower limbs were significantly higher than that of upper limbs. The complication did not happen after general anesthesia.Nineteen of them were healing well and discharged. Conclusion Proper anesthetic management could improve the success and the prognosis of corrective surgery in infant with interrupted aortic arch.

关 键 词：主动脉弓中断 深低温停循环 全身麻醉 婴幼儿 

分 类 号：R541.1[医药卫生—心血管疾病]