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目的报告心脏跳动心内直视手术在婴幼儿中应用体会。方法回顾分析420例婴幼儿手术的临床资料,本组患儿均采用全身静脉复合麻醉,常规建立体外循环,置左心房引流管,降温至(32±1)℃并维持,仅阻断上下腔静脉,不阻断主动脉,维持灌注压在60mmHg(1mmHg=0133kPa),心脏跳动下进行心内畸形矫正,方法同停跳下手术。结果早期手术死亡20例(死亡率48%),其中低心排出量综合征死亡13例,右心功能衰竭死亡2例,严重低氧血症死亡1例,心律紊乱死亡2例,急性肝、肾功能衰竭死亡各1例。术后残余室间隔微量分流2例。其余均痊愈出院,恢复良好。结论心脏跳动中心内直视手术在婴幼儿先天性心脏病中应用有较好的疗效,是一种安全的心内直视手术技术。
Objective To report heart beating heart open surgery in infants and young children experience. Methods The clinical data of 420 infants and toddlers were retrospectively analyzed. All patients underwent intravenous anesthesia with general anesthesia. Cardiopulmonary bypass was established routinely. Left atrium drainage tube was placed, and the temperature was reduced to (32 ± 1) ℃ and maintained. Only the upper and lower chambers were blocked Venous, do not block the aorta, maintain perfusion pressure in 60mmHg (1mmHg = 0133kPa), heart beating correction of intracardiac deformity, the method of surgery with the jump. Results Early surgical death in 20 cases (48% mortality), including low cardiac output syndrome in 13 cases, 2 cases of right heart failure, severe hypoxemia in 1 case, 2 cases of arrhythmia death, acute liver, 1 case of renal failure and death. Postoperative residual ventricular septal minor shunt in 2 cases. The rest were cured and discharged, recovered well. Conclusions Open heart surgery in the heart beating heart surgery in infants with congenital heart disease has a good effect, is a safe surgical technique of open heart surgery.