目的探讨婴幼儿围心脏手术期血乳酸浓度的变化与疾病预后的关系。方法1227例体外循环(extracor-poreal circulation,ECC)下实施手术的小儿先天性心脏病患者,常规测定术前、ECC前、ECC 30 m in、ECC停止1h、术后24h及术后48h的动脉血乳...目的探讨婴幼儿围心脏手术期血乳酸浓度的变化与疾病预后的关系。方法1227例体外循环(extracor-poreal circulation,ECC)下实施手术的小儿先天性心脏病患者,常规测定术前、ECC前、ECC 30 m in、ECC停止1h、术后24h及术后48h的动脉血乳酸含量。比较按年龄、存活与否、小儿恢复室(PICU)滞留时间分组后的血乳酸值。结果存活组和死亡组的乳酸值在ECC后最高,以后逐渐降低,两组各时点的血乳酸值比较,死亡组明显高于存活组(P<0.05)。滞留9天以内的各组间血乳酸值无显著性差异,滞留9天以上组术前、ECC前、术后24h、48h时点明显高于其它各组(P<0.05)。新生儿组及学龄儿组从ECC后1h到术后24h血乳酸值明显上升,学龄儿组的高乳酸血症第二天恢复,但新生儿组仍维持在较高水平。结论测定婴幼儿先天性心脏病患者的围术期血乳酸浓度的变化可以作为评价疾病预后的一个敏感性指标。展开更多
Coarctation of the aorta is a relatively common form of congenital heart disease, with an estimated incidence of approximately 3 cases per 10000 births. Coarctation is a heterogeneous lesion which may present across a...Coarctation of the aorta is a relatively common form of congenital heart disease, with an estimated incidence of approximately 3 cases per 10000 births. Coarctation is a heterogeneous lesion which may present across all age ranges, with varying clinical symptoms, in isolation, or in association with other cardiac defects. The first surgical repair of aortic coarctation was described in 1944, and since that time, several other surgical techniques have been developed and modified. Additionally, transcatheter balloon angioplasty and endovascular stent placement offer less invasive approaches for the treatment of coarctation of the aorta for some patients. While overall morbidity and mortality rates are low for patients undergoing intervention for coarctation, both surgical and transcatheter interventions are not free from adverse outcomes. Therefore, patients must be followed closely over their lifetime for complications such as recoarctation, aortic aneurysm, persistent hypertension, and changes in any associated cardiac defects. Considerable effort has been expended investigating the utility and outcomes of various treatment approaches for aortic coarctation, which are heavily influenced by a patient's anatomy, size, age, and clinical course. Here we review indications for intervention, describe and compare surgical and transcatheter techniques for management of coarctation, and explore the associated outcomes in both children and adults.展开更多
文摘目的探讨婴幼儿围心脏手术期血乳酸浓度的变化与疾病预后的关系。方法1227例体外循环(extracor-poreal circulation,ECC)下实施手术的小儿先天性心脏病患者,常规测定术前、ECC前、ECC 30 m in、ECC停止1h、术后24h及术后48h的动脉血乳酸含量。比较按年龄、存活与否、小儿恢复室(PICU)滞留时间分组后的血乳酸值。结果存活组和死亡组的乳酸值在ECC后最高,以后逐渐降低,两组各时点的血乳酸值比较,死亡组明显高于存活组(P<0.05)。滞留9天以内的各组间血乳酸值无显著性差异,滞留9天以上组术前、ECC前、术后24h、48h时点明显高于其它各组(P<0.05)。新生儿组及学龄儿组从ECC后1h到术后24h血乳酸值明显上升,学龄儿组的高乳酸血症第二天恢复,但新生儿组仍维持在较高水平。结论测定婴幼儿先天性心脏病患者的围术期血乳酸浓度的变化可以作为评价疾病预后的一个敏感性指标。
文摘Coarctation of the aorta is a relatively common form of congenital heart disease, with an estimated incidence of approximately 3 cases per 10000 births. Coarctation is a heterogeneous lesion which may present across all age ranges, with varying clinical symptoms, in isolation, or in association with other cardiac defects. The first surgical repair of aortic coarctation was described in 1944, and since that time, several other surgical techniques have been developed and modified. Additionally, transcatheter balloon angioplasty and endovascular stent placement offer less invasive approaches for the treatment of coarctation of the aorta for some patients. While overall morbidity and mortality rates are low for patients undergoing intervention for coarctation, both surgical and transcatheter interventions are not free from adverse outcomes. Therefore, patients must be followed closely over their lifetime for complications such as recoarctation, aortic aneurysm, persistent hypertension, and changes in any associated cardiac defects. Considerable effort has been expended investigating the utility and outcomes of various treatment approaches for aortic coarctation, which are heavily influenced by a patient's anatomy, size, age, and clinical course. Here we review indications for intervention, describe and compare surgical and transcatheter techniques for management of coarctation, and explore the associated outcomes in both children and adults.
