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目的：回顾总结１９４例体重１０ｋｇ以下婴幼儿先天性心脏病围术期处理经验，探讨适合低体重婴幼儿特点的围术期处理常规。方法：患儿年龄３～３６个月，平均１４．７±１０．８个月；体重３．０～９．５ｋｇ，平均７．７±２．３ｋｇ。围术期处理主要采取以下措施：①术前完善各项检查，积极治疗肺炎、心力衰竭、贫血等并发症。②术后早期根据患儿肺部病变情况，动态地调整呼吸机参数，不主张长时间应用大潮气量、大呼气末正压的通气方式，适时选择拔管时机。③合理调整术后容量，避免短时间内输入大量库血，早期适量应用正性肌力药物改善心功能，对紫绀型小婴儿重视纠正低钙血症。结果：１９４例患儿中３０例（１５．４６％）出现术后并发症，死亡８例（４．１２％），主要原因为心跳骤停、肺动脉高压及多器官衰竭。结论：探讨并建立适合体重１０ｋｇ以下婴幼儿特点的围术期处理常规，这有助于降低术后并发症，减少死亡率。
OBJECTIVE: To review the experience of perioperative management of 194 cases of infants with congenital heart disease under 10kg, and to discuss the perioperative management routine for the characteristics of infants with low birth weight. Methods: Children aged 3 to 36 months, an average of 14.7 ± 10.8 months; body weight 3.0 ~ 9.5kg, an average of 7.7 ± 2.3kg. Perioperative management to take the following measures: ① preoperative perfection of the examination, active treatment of pneumonia, heart failure, anemia and other complications. ② early postoperative early according to the condition of children with pulmonary lesions, dynamic adjustment of ventilator parameters, do not advocate a long time to apply large tidal volume, expiratory positive pressure ventilation, timely selection of the timing of extubation. ③ Reasonable adjustment of postoperative capacity to avoid a large number of short-term storage of blood, the early application of inotropic drugs to improve cardiac function, cyanotic baby attention to correct hypocalcemia. Results: Postoperative complications occurred in 30 (15.46%) of 194 infants with 8 deaths (4.12%), mainly due to cardiac arrest, pulmonary hypertension and multiple organ failure. Conclusion: To discuss and establish the perioperative management routine suitable for infants and young children weighing less than 10kg, which will help to reduce postoperative complications and reduce mortality.