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目的探讨婴儿重症先天性心脏病(CHD)急诊手术的麻醉管理方法,以提高该类手术的麻醉的成功率。方法回顾性总结该院2005年12月至2009年3月260例婴儿重症CHD急诊手术的麻醉管理方法。确诊后24 h内接受外科手术治疗的重症CHD患儿,诱导后经鼻行气管插管,压力控制模式行机械通气。监测吸入呼吸道压力,潮气量,呼吸频率,呼气末CO2。根据患儿病理生理特点,调节通气参数和血流动力学指标。停体外循环(CPB)后维持血流动力学平稳。结果围术期血流动力学平稳,全组无麻醉并发症。结论术前积极地对症处理,术中合理地进行麻醉、呼吸、循环管理,可有效地提高手术成功率。
Objective To explore the method of anesthesia management in emergency operation of infants with severe congenital heart disease (CHD) to improve the success rate of anesthesia in this kind of surgery. Methods A retrospective summary of the hospital from December 2005 to March 2009 260 cases of severe CHD emergency operation anesthesia management. Severe CHD children undergoing surgical treatment within 24 hours after diagnosis were given mechanical ventilation after nasal intubation and pressure control mode. Inhaled respiratory pressure, tidal volume, respiratory rate, end-tidal CO2. According to the pathophysiology of children, regulate ventilation parameters and hemodynamic parameters. Halt cardiopulmonary bypass (CPB) to maintain hemodynamic stability. Results Perioperative hemodynamic stability, the whole group without complications of anesthesia. Conclusion Positive symptomatic treatment before surgery, intraoperative reasonable anesthesia, breathing, circulation management, can effectively improve the success rate of surgery.