摘要
目的 探讨新生儿、小婴儿先心病体外循环手术围手术期处理的方法和效果。方法 回顾性地分析、总结2 0 0 1～ 2 0 0 3年在我院体外循环手术治疗的患有重症先心病的新生儿和年龄 <6个月的小婴儿在围手术期所采用的处理办法并分析这些处理方法的效果。结果 术前心衰、难治肺炎患儿抗感染、强心、利尿、扩血管、支持等处理。术中加强麻醉管理、超滤等处理。术后用多巴胺、多巴酚丁胺、力其丁、肾上腺素、硝普钠、米力农等心血管药物和腹膜透析防治低心排 ;用肺动脉测压管监测肺动脉压 ,镇静、肌松、充分给氧、及时纠正酸中毒、肺血管扩张剂等措施防治术后肺动脉高压危象 ;手术死亡 7例 ,死亡率为 10 .94 % ;术后发生低心排 16例、肺动脉高压危象 6例 ,分别死亡 3例和 2例。结论 新生儿、小婴儿重症先心病体外循环手术有良好效果 ;加强术前、术中、术后整个围手术期的处理对手术成功致关重要 ;术后低心排、肺动脉高压危象是手术死亡的重要原因。
Objectives to study the perioperative managements and its effects on the neonates and small infants with congenital heart defects ,operated with cardiopulmonary bypass Methods Rertospectively analyse what measures have been taken to treat the neonates and small infants with congenital heart defects during operations with cardiopulmonary bypass and analyse the results.Results 64 neonates and infants operated; antibiotics、cardioc stimulant、diuretics、casodilator substances were used before some operations;Strenthenned anesthesia,using ultrafiltration during cardiopulmonary bypass; dopamine, dobutamine,regitine,milrinone and peritoneal dialysis were used to treat low output cardiac syndrome(LOCS);monitoring pulmonary pressure ,sedating,paralyzing, hyperventilation, pulmonary vascular dilation and correcting acidosis were used to treat pulmonary hypertensive crises;the general mortality was 10.92 %(7/64).the morbidity of LOCS and pulmonary hypertensive crises were 25%(16/64) and 9.38%(6/64),died 3 and 2 separately.Conclusions Surgical treatment with cardiopulmonary bypass for neonates and infants ,suffered from severe congenital heart defects ,have good results;the perioperative treatments play a important role in the procedures;LOCS and pulmonary hypertensive crises were the main causes of mortality.
出处
《岭南心血管病杂志》
2004年第4期274-276,280,共4页
South China Journal of Cardiovascular Diseases
关键词
新生儿
小婴儿
重症先心病
外科治疗
围手术期处理
术后并发症
Infant
Heart defects,congenital
Perioperative treatment
Low cardiac output syndrome
pulmonary hepertenssive crisis
