摘要
目的 总结儿童瓣膜置换术的体外循环管理。方法 回顾我院自 1989年到 2 0 0 1年共 74例儿童瓣膜置换术的体外循环情况 ,包括血液稀释、灌注方式、心肌保护并进行分析。结果 体外循环时间 51～ 166min ,平均 83min ,主动脉阻断时间 3 2～ 12 4min ,平均 67min ;心脏自动复跳 69例 ,占 93 % ,电击复跳 5例 ,占 7% ;全组死亡 8例 ,死亡率10 8% ,主要死因为低心排综合征、多器官衰竭、大出血和呼吸衰竭。结论 在儿童瓣膜置换术的体外循环管理中 ,认真作好术前准备 ,根据患儿的体重、病种选好相应的设备、血液稀释和灌注方法 ,在体外循环中保证充沛的组织灌注 ,注重心肺等器官的保护 ,心脏复跳后掌握好辅助循环的要求等综合措施 ,是提高手术的成功率。
Objectives To summarise the management of cardiopulmonary bypass(CPB) in 74 children undergoing heart valve replacement. Methods The management of CPB including hemodiltion,perfusion pattern and myocardial protection in 74 children undergoing heart valve replacement were analyzed retrospectively in our hospital during the period from 1989 to 2001. Results The CPB time ranged from 51 to 166 min,mean 83 min,the aortic crossing clamping time 32～124 min, mean 67 min; Heart beat returned spontaneously in 69 cases occupied 93%, 5 cases with electric shock occupied 7%. 8 cases died perioperatively. The morbidity was 10 8%. The main causes were lower cardiac output syndrome,multi organ function failure. Conclusions The management of CPB for children undergoing heart valve replacement should be include: ①careful preoperative preparation ②equipment choice ③hemodilution and ④ perfusion method according to the childrens weight and heart abnormality. Attentions must be payed to enough perfusion of tissues, protection of important organ function during bypass and good circulation assist after heart resuscitation.
出处
《岭南心血管病杂志》
2003年第4期252-253,共2页
South China Journal of Cardiovascular Diseases
