摘要
目的评价左右心房联合测压导管(简称联管)用于心脏手术围术期左心房压力监测的可行性、准确性和安全性。方法选取40例术中需左心房压力监测的复杂先天性心脏病手术患儿。年龄1～4岁;体质量8～15kg。麻醉诱导和维持采用静脉和吸入复合全身麻醉方法,行气管插管和机械通气。麻醉诱导后,经右侧颈内静脉分别置入联管和单腔导管至左心房。联管是由5.5-F的改良三腔中心静脉导管和内置于中心腔的微导管组成,微导管长于改良三腔导管。单腔管是20G的中心静脉导管,为常规使用的左心房留置导管。手术期间,在完成心内修补后将微导管和单腔管尖端经房间隔放入左心房。记录手术结束时和回到恢复室后的二管压力测定值,并评估操作难易程度和并发症发生率。结果联管左心房压力测定值与单腔管左心房压力测定值明显相关,手术结束时压力值的相关系数r=0.974(P=0),回恢复室左心房压力测定值的相关系数r=0.949(P=0)。留置导管期间和围术期无导管相关并发症的发生,所有患儿无死亡。结论联管测定左心房压力值与单腔管相近,数据准确,无导管相关并发症,可替代单腔导管监测左心房压力。
Objective To evaluate the feasibility, accuracy and safety of a new combined left and right atrial catheter for monitoring left atrial pressure in pediatric cardiac patients. Methods Forty patients,aged 1 to 4 years and weighted 8 - 15 kg, were observed following complex congenital ＂heart defect repair. Anesthetic induction and maintenance were conducted by combined intravenous and inhalational agents. Patients were intubated and ventilated by mechanical mechine. After anesthetic induction, the combined catheter and single - lumen catheter were placed into left atrium in the same patient through right jugular vein. The combined catheter was made of a 5.5 - F modified triple - lumen catheter and a longer microtube ,which inserted into the central lumen of triple - lumen. The single lumen catheter was a regular 20 G single catheter for mornitoring left atrial pressure. The distal ends of microtube and single - lumen catheter were repositioned transseptally and advanced into the left atrium after repair of intracardiac defect. The eases of catheter placement and pressure measured by both catheters were compared. Results There were significant correlations between left atrial pressures measured by microtube and by single - lumen catheter at end of operation and Pediatric Intensive Care （ r = 0. 974, 0. 949 Pa 〈 0.01 ）. No mortality or catheter - related complication were observed. Conclusions Microtube inserted into the triple - lumen catheter might be an alternative to single - lumen catheter for monitoring left atrial pressure in pediatric cardiac surgery.
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2009年第12期959-961,共3页
Journal of Applied Clinical Pediatrics
关键词
左房管
左心房压力
心脏手术
左右心房联合测压导管
left atrial catheter
left atrial pressure
cardiac operation
combined left and right atrial catheter
