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1. 重庆医科大学附属儿童医院心胸外科
2. 重庆医科大学附属儿童医院麻醉科
3. 重庆医科大学附属儿童医院重症监护室
纸质出版日期:2009,
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[1]李勇刚,李洪波,王刚,吴春,潘征夏,杨杰先,徐红珍,谭利平.婴幼儿先天性心脏病的急诊和亚急诊外科治疗[J].重庆医科大学学报,2009,34(06):763-765.
LI Yong-gang, et al. Emergency and sub-emergency cardiac operations on congenital heart defects in children[J]. Journal of Chongqing Medical University, 2009,34(6):763-765.
目的:总结婴幼儿先天性心脏病急诊和亚急诊外科治疗经验
探讨其临床价值。方法:2002年1月~2008年4月行急诊和亚急诊手术治疗危重先天性心脏病婴幼儿172例。其中术前反复呼吸道感染或充血性心力衰竭113例
低氧血症62例
其他危重情况5例。行根治手术149例
姑息手术23例。结果:全组术后早期死亡15例
死亡率为8.7%(15/172)。术后呼吸机辅助呼吸时间5h~31d(平均3.1±4.9d)
ICU停留时间2~31d(平均5.8±2.5d)。术后并发症包括低心排血量综合征17例
肺不张12例
肺部感染35例
肺动脉高压危象5例
胸腔积液5例。随访2~73个月
晚期死亡2例
存活患儿心功能Ⅰ~Ⅱ级。结论:急诊和亚急诊手术治疗危重先天性心脏病是必要和可行的。正确的围术期处理和合理的手术方式是取得良好效果的关键。
Objective:To summarize and evaluate emergency and sub-emergency cardiac operations on congenital heart defects in children.Method:From January 2002 to April 2008
emergency and sub-emergency cardiac operations were performed on 172 children(105 males
67 females) with critical congenital heart defects.The age was 5 days~33 months(mean 10.2 ± 8.7 months)
and the weight was 2.7 ~13.6 kg(mean 8.2 ± 4.8 kg).Thepreoperative situation included recurrent respiratory infection or congestive heart failure(113 cases)
severe hypoxemia(62 cases) and other critical conditions(5 cases).Corrective operations were performed on 149 cases and palliative operations on 23 cases.Results:The early postoperative mortality was 8.7%(15/172).The duration of intubation was 5 hours~31 days(mean 3.1±4.9 days)
and the ICU stay time was 2 ~31 days(mean 5.8 ± 2.5 days).Postoperative low cardiac output syndrome was observed in 19 cases
atelectasis in 12 cases
lung infection in 35 cases
worsened pulmonary hypertension in 5cases
and pleural effusion in 5 cases.There were 2 late deaths during follow-up period of 2~73 months.The postoperative cardiac function of the 155 survivals was restored to grade I~II(NYHA).Conclusion:Emergency and sub-emergency cardiac operations on critical congenital heart defects in children are necessary and feasible.Good results can be achieved with appropriate perioperative management and surgical technique.
婴幼儿先天性心脏病急诊手术
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