低体重婴儿复杂性先天性心脏病手术的体外循环管理  

Management of extracorporeal circulation during complex congenital heart surgery in infants with low weight

作　　者：王蕾 陈良万[1] 杨立平[1] 杜剑之[1] 吕晓钗[1] 侯艳婷 Wang Lei;Chen Liangwan;Yang Liping;Du Jianzhi;Lv Xiaochai;Hou Yanting(Department of Cardiac Surgery,Union Hospital of Fujian Medical University,Fuzhou 350001,China)

机构地区：[1]福建医科大学附属协和医院心脏外科

出　　处：《中国体外循环杂志》2019年第6期337-340,共4页Chinese Journal of Extracorporeal Circulation

摘　　要：目的总结低体重婴儿复杂性先天性心脏病手术的体外循环(ECC)管理方法和经验。方法回顾70例低体重婴儿复杂性先天性心脏病手术的ECC管理要点及临床资料。结果全组ECC转流时间(115.38±35.48)min,主动脉阻断时间(65.32±28.15)min,均顺利停机,术后机械通气时间(60.0±47.2)h,ICU停留时间(5.7±3.8)d,术后并发重症肺炎4例,并发肾功能不全3例,术后并发低心排早期死亡1例,死亡率1.43%。结论优化预充,维持合适的红细胞比容及灌注流量,加强液体出入平衡的管理,良好的心肌保护,是减少低体重婴儿复杂性先天性心脏病术后并发症及死亡率的ECC技术关键。Objective To summarize the experience of extracorporeal circulation(ECC)management during complex congenital heart surgery in infants with low weight.Methods The ECC management and clinical data of 70 cases of complex congenital heart surgery in infants with low weight were reviewed.Results The ECC time was(115.38±35.48)min,and aortic cross clamping time was(65.32±28.15)min.All patients weaned off ECC successfully.The postoperative mechanical ventilation time was(60.0±47.2)h,and the ICU stay time was(5.7±3.8)d.Four cases were complicated with severe pneumonia and 3 cases were complicated with renal insufficiency after the operation.One patient died early postoperatively due to low cardiac output,with a mortality rate of 1.43%.Conclusion Optimizing ECC priming,maintaining the appropriate hematocrit and perfusion flow,strengthening the management of fluid balance and good myocardial protection are the keys to reduce the complications and mortality of complex congenital heart surgery in infants with low weight after ECC surgery.

关 键 词：体外循环 复杂性先天性心脏病 低体重婴儿 预充 超滤 

分 类 号：R65[医药卫生—外科学]