局解手术学杂志2011，Vol.20Issue(5)：477-479,3.
重症婴儿先天性心脏病手术的体外循环策略
Cardiopulmonary bypass strategies of surgical treatment for severe congenital heart disease in infant
王咏 1肖颖彬 1王学锋 1陈林 1彭莉 1胡卫 1刘梅1
作者信息
- 1. 第三军医大学新桥医院全军心血管外科中心,重庆,400037
- 折叠
摘要
Abstract
Objective To analyze the cardiopulmonary bypass strategies of surgical trealmenl for severe congenital heart disease in in-fant. Methods The clinical dala of 354 infanls wilh severe congenilal heart disease underwent open heart surgery were retrospectively analyzed. Complicalions relaled Lo cardiovascular syslem, respiralory syslem, digeslive syslem were occurred in 318 cases (89. 8% ). Mild hy-polhemia cardiopulmonary bypass (CPB) wilh healing heart , moderate hypothermia CPB, profound hypolhermia low flow perfusion CPB and profound hypolhermia circulation arresled CPB were performed according lo differenl procedures. Heart arresl was performed by open heart surgery wilhoul occluding aorta and infusion of cold blood fluid through aortic root in proportion as 4:1 (274 cases). Paralleled and modified ullrafillralion were executed after rewarming. Results The duralion of CPB wilhoul heart healing was (112. 11 ±31. 37) minules and that of aortic occlusion was (56. 12 ±22. 17) minules. The duralion of CPB wilh heart healing was (79. 3 ± 19. 1) minules and lhal of vena cava occlusion was (39. 1 ±11.8) minules. Heart sugery under profound hypolhermia circulation arresled CPB was performed on four cases, the duralion of CPB was 114 ~ 161 minules, those of aortic occlusion and occlusion arresl were 56 ~ 161 minules and 5 ~ 16 minules. Tolally 253 cases(92. 3% ) recovered heart healing automatically after removing clamp. There were 8 cases experienced difficulty in slopping circulation, 11 cases died, the mortality rale was 3. 1% . Conclusion Reasonable priming,high quality of membrance oxygenalor during CPB,corrected CPB plans and modified ullrafillralion were keys lo improve CPB for critical infanls with CHD.关键词
先天性心脏病/体外循环/婴儿Key words
congenilal heart disease/ cardiopulmonary bypass/ infant分类
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王咏,肖颖彬,王学锋,陈林,彭莉,胡卫,刘梅..重症婴儿先天性心脏病手术的体外循环策略[J].局解手术学杂志,2011,20(5):477-479,3.
