摘要
【目的】分析本院外科手术治疗的36例新生儿先天性心脏病婴儿的临床资料,总结新生儿先心病的围手术期处理经验。【方法】全组患儿均在体外循环下行一期根治术,术前给予控制感染、纠正心衰、增加心功能储备等处理,术后给予呼吸、循环管理,治疗并发症等处理。【结果】①21例未出现并发症,术后(11.91±3.65)d痊愈出院。12人出现并发症,共32例次,均痊愈出院。死亡3例,病死率8.33%。均为复杂性先心病患儿,死于重度低心排综合征。②比较患儿入院、出院时呼吸频率、心率、肝脏大小,结果均有显著统计学意义(P<0.05)。③分析患儿术前、术后10 d所做心脏彩超数据,结果表明:射血分数、舒张末期左室内径、每分钟心输出量、舒张末期左室容积均无明显差异(P>0.05),合并肺动脉高压患儿出院时平均肺动脉压、肺动脉内径较术前明显下降(P<0.05)。【结论】先天性心脏病手术宜早期进行。合理的围手术期治疗,是提高新生儿先心病手术成功率的关键。
[Objective]To analyze the clinical data of 36 neonatal infants with congenital heart disease （CHD） in our department from January 2000 to January 2005, and review the experience of perioperative management for CHD. [Methods] All these small infants were operated radically by cardiopulmonary bypass. Controlling infection, redressing heart failure and improving the reserve of heart function were given before operation, and synthetical management including the guarding of respiration, management of circulation and treatment of complications were given after operation. [Results]（1）There were 21 cases without complication who recovered and got out of hospital days（11. 91±3. 65） after operation. Twelve infants occurred complications. The common complications were arrhythmias, pulmonary complications, renal failure and low cardiac output in turn. They all recovered and got out of hospital. Three cases who had complicated with CHD were dead. The hospital mortality rate was 8.33%. The cause of death was severe low cardiac output syndrome. （2） There was significant difference in respiratory rate, heart rate and the size of liver （ P 〈0.01, P 〈0.05, P〈 0.01）. （3）There was no significant difference in ejection fraction （EF）,FS, cardiac output （CO） and EDV （ P 〉0.05）. Mean pulmonary arterial pressure （MPAP） （ P 〈0.01） and inside diameter of pulmonary artery （ P 〈0.05） of patients complicated with pulmonary artery hypertension were obviously declined compared to that of patients before operation. [Conclusion]The small infants with CHD should be early operated. The proper perioperative management is the key to improve successful rate of operation in infants with CHD.
出处
《医学临床研究》
CAS
2007年第11期1864-1866,共3页
Journal of Clinical Research
