中国体外循环杂志2025，Vol.23Issue(3)：215-218,4.DOI:10.13498/j.cnki.chin.j.ecc.2025.03.05
产时新生儿心脏手术心肺转流管理经验
Experience in management of cardiopulmonary bypass during intrapartum cardiac surgery
摘要
Abstract
Objective To summarize the management of cardiopulmonary bypass(CPB)during delivery of critical congenital heart disease.Methods From December 2022 to April 2024,a total of 10 neonates with severe congenital heart disease underwent intrapartum surgery in the Pediatric Heart Center of our hospital.The clinical data,CPB management data,cardiac laboratory examinations before and after surgery,and postoperative clinical results were retrospectively analyzed.Results CPB time of all neonates was(167.40±75.18)min and aortic occlusion time was(107.80±57.18)min.All neonates were stopped without delayed chest closure.The average dosage of heparin during CPB was(5.50±1.37)mg/kg.Blood bank pre-charge was(0.8-1)U;Improved ultrafiltration time was(9.1±1.29)min;Total filtrate volume was(469±96.15)ml;Protamine dosage was(9.54±1.48)mg/kg.One patient underwent a second tricuspid valvuloplasty 45 days after surgery due to moderate and severe tricuspid regurgitation.One patient died of low cardiac output due to hypertrophy obstruction of ventricular septum.9 patients recovered successfully after operation and were discharged from hospital.Conclusion Intrapartum neonatal cardiac surgery can provide a new safe and earlier surgical treatment opportunity for children with complex and critical congenital heart disease under the close cooperation of multidisciplinary teams.CPB management involves the precise control of consumables selection,blood storage pre-filling,anticoagulation optimization,flow and blood pressure control,etc.It is very important to monitor oxygen supply and consumption during CPB.关键词
心肺转流/危重/先天性心脏病/新生儿/产时心脏手术Key words
Cardiopulmonary bypass/Critical/Congenital heart disease/Newborn/Intrapartum cardiac surgery引用本文复制引用
缪娜,张晓娟,赵雪婷,王佳露,汪晓南,王强,赵举..产时新生儿心脏手术心肺转流管理经验[J].中国体外循环杂志,2025,23(3):215-218,4.基金项目
首都医科大学附属北京安贞医院重大科技创新研发专项基金(KCZD202202) （KCZD202202）
