深低温停循环与区域性脑灌注婴儿学龄前社会生活能力随访  

Follow-up of the preschool social life abilities of children who underwent deep hypothermic circulatory arrest or regional cerebral perfusion in infancy

作　　者：彭文英[1,2] 庄建[1,2] 陈寄梅[1,2] 陈萍[1,2] 罗丹东[1,2] 

机构地区：[1]广东省心血管病研究所心脏外科 [2]广东省人民医院广东省医学科学院,广州510100

出　　处：《岭南心血管病杂志》2012年第6期594-597,共4页South China Journal of Cardiovascular Diseases

基　　金：国家十二五科技支撑计划(项目编号:2011BAI11B22)

摘　　要：目的评估心血管手术中使用深低温停循环(deep hypothermic circulatory arrest,DHCA)与区域性脑灌注(regional cerebral perfusion,RCP)的婴儿学龄前社会生活能力水平,评价DHCA与RCP的脑保护效果。方法选取2007年4月至2009年2月在广东省人民医院接受DHCA和RCP行主动脉合并心内畸形矫治手术的患儿(日龄≤90 d或体质量≤6.0 kg),排除死亡及失访患儿后,参与随访的共32例,男26例,女6例;手术日龄14～187 d,中位日龄55 d;手术时体质量(4.2±0.8)kg。其中,DHCA组15例,RCP组17例,随访时间分别为(57.2±5.9)个月与(53.2±9.4)个月。采用从《婴儿-初中生社会生活能力量表》,从独立生活、运动、作业操作、交往、集体活动、自我管理6个方面对患儿进行评估,测出其社会生活能力水平。结果 DHCA组有1例患儿术后反复肺炎,生长发育差,作业操作、交往能力评分等级为轻度低下,独立生活、运动、集体活动、自我管理评分为边缘;另1例患儿集体活动评分为边缘。RCP组有1例患儿交往能力评分为边缘。其余患儿在作业操作、交往、独立生活、运动、集体活动、自我管理6个方面社会生活能力均正常。两组患儿在作业操作、交往、独立生活、运动、集体活动、自我管理6个方面评分比较,差异均无统计学意义(P>0.05)。结论婴幼儿主动脉手术使用DHCA与RCP对患儿学龄前社会生活能力无明显影响,DHCA与RCP有相似的脑保护效果。Objectives To evaluate the cerebral protective effects of deep hypothermic circulatory arrest （DHCA） and regional cerebral perfusion （RCP） by following up the preschool social life abilities of children who underwent cardiac surgery with DHCA or RCP in their infancy. Methods Those who died or failed to respond were excluded. Then 32 patients （26 males and 6 females） who underwent aortic surgical procedures with DHCA or RCP in their infancy （age ≤ 90 d or weight ≤6.0 kg） from April 2007 to February 2009 received preschool social life ability assessments. They aged from 14 to 187 days （median 55 days） and weighed （4.2±0.8） kg at the time of the operation. Among them, 15 patients were in DHCA group and 17 in RCP group. The mean follow-up duration were （57.2±5.9） months and （53.2±9.4） months in DHCA group and RCP group respectively. Social life ability scale for infant-junior middle school students was adopted to assess the children＇s social life abilities, including independence, sports, operation, communication, collective activities and self-management. Results In DHCA group, one case had pneumonia repeatedly and was in bad condition on physical growth and development. His scores of operation and communication were slightly low; scores of independence, sports, collective activities and self-management were in rim condition. The score of collective activities of another case was in rim condition. There was one child with rim condition on communication ability in RCP group. The rest children had normal scores in operation, communication, independence, sports, collective activities and self-management. There were no significant differences in independence, sports, operation, communication, collective activities and self-management between the two groups （P〉0.05）. Conclusions DHCA and RCP used in infant aortic surgery do not impair children＇s social life abilities at their preschool age and they have similar cerebral protective effects.

关 键 词：主动脉疾病 心脏外科手术 深低温停循环 婴幼儿 随访 

分 类 号：R543.1[医药卫生—心血管疾病]