论文部分内容阅读
目的 提高重症先天性心脏病患儿的成活率。方法 随机选择 32例拟行手术治疗的心间隔缺损并重度肺动脉高压、双向分流的患儿为研究对象。年龄 4个月～ 12岁 ,平均 4 3岁 ,体重 4 5～ 2 7kg ,平均 9 6kg,≤2岁者 18例 ,>2岁者 14例 ;单纯室间隔缺损 16例 ,室间隔 +房间隔缺损 5例 ,室间隔缺损 +动脉导管未闭 7例 ,室间隔缺损 +房间隔缺损 +动脉导管未闭 3例 ,完全性心内膜垫缺损 1例。术前采用合适的药物治疗 ,控制肺动脉压达满意水平 10～ 15d ,术后坚持使用药物治疗的同时延长呼吸机辅助时间 ,以维持适宜的血气指标在满意的水平。结果 本组 32例 ,治愈 2 9例 ,术后并发肺高压危象 9例 ,右心功能衰竭 3例 ,频发室性早搏 3例 ,低心输出量综合征 4例 ,共死亡 3例。结论 对心间隔缺损并重度肺动脉高压、双向分流者的围术期综合治疗是提高手术成功率的重要环节
Objective To improve the survival rate of children with severe congenital heart disease. Methods Thirty-two children undergoing surgical treatment of cardiac septal defect with severe pulmonary hypertension and bilateral shunt were randomly selected as the study subjects. Aged 4 months to 12 years old, average 43 years old, weighing 45 to 27kg, an average of 9 6kg, ≤ 2 years old in 18 cases,> 2 years old in 14 cases; simple ventricular septal defect in 16 cases, ventricular septal + atrial septal 5 cases of defect, ventricular septal defect + patent ductus arteriosus in 7 cases, ventricular septal defect + atrial septal defect + patent ductus arteriosus in 3 cases, complete endocardial cushion defect in 1 case. Preoperative use of appropriate drug treatment, control of pulmonary artery pressure to a satisfactory level of 10 ~ 15d, adhere to the use of drugs after surgery to extend ventilator support time to maintain appropriate blood gas levels at satisfactory levels. Results The group of 32 patients, cured 29 cases, postoperative pulmonary hypertension crisis in 9 cases, 3 cases of right heart failure, frequent premature ventricular contractions in 3 cases, 4 cases of low cardiac output syndrome, a total of 3 deaths. Conclusion Perioperative comprehensive treatment of patients with atrial septal defect and severe pulmonary hypertension and bi-directional shunting is an important part of improving the success rate of surgery