低体重婴儿先天性心脏病的体外循环策略及外科疗效  

Extracorporeal circulation management and surgical prognosis in low body weight infants with congenital heart disease

作　　者：石海燕[1] 马浩[1] 王立新[1] 薛炎[1] 邱立成[1] 张晓[1] 王奇[1] 

机构地区：[1]武警总医院心血管外科,北京100039

出　　处：《武警医学》2013年第10期889-891,共3页Medical Journal of the Chinese People's Armed Police Force

摘　　要：目的探讨低体重先天性心脏病患儿的体外循环管理方法和外科预后。方法回顾性分析我院2008-2012年共297例月龄≤12个月且体重≤10 kg的先天性心脏病患儿行心内直视术的体外循环方法,总结围术期并发症及死亡情况。结果体外循环时间16～122(57.4±13.9)min,主动脉阻断时间6～95(35.1±11.3)min,均采用改良超滤+平衡超滤,围术期低心排综合征26例,急性呼吸窘迫综合征33例,重症肺部感染9例,肾衰竭5例,延迟关胸5例,围术期死亡5例。结论合理的预充和灌注,采用超滤并重视脏器的保护,是低体重先天性心脏病患儿体外循环管理的合理策略,可以有效改善手术预后。Objective To review and analyze the extracorporeal circulation method and clinical prognosis in the infants with congenital heart disease who have low months age and low body weight. Methods The extracorporeal circulation mothod and curative effect in 297 infants weighting below 10 kg and age below 12 months with congenital heart disease from January 2008 to December 2012 in this hospital were summarized. Results Extracorporeal circulation time was 16-122 （mean 57.4？13.9） min, aortic cross-clamp time was 6-95 （mean 35.1？11.3） min, ultrafiltration techniques were used for all cases. After operation, 26 infants suffered from low cardiac output syndrome, 33 ARDS, 9 pneumonia, 5 renal failure, 5 delayed sternal closure and 5 infants died perioperatively. Conclusions Reasonable priming perfusion, ultrafiltration technique and organ protection were effective ways in extracorporeal circulation management of infants with congenital heart disease who have low body weight.

关 键 词：低体重 体外循环 预后 

分 类 号：R726.1[医药卫生—儿科]