| 危重新生儿心内直视术的体外循环管理 |
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| 引用本文： | 张倬,柯俊,王晟,庄建,陈寄梅,岑坚正. 危重新生儿心内直视术的体外循环管理[J]. 临床急诊杂志, 2011, 12(1): 9-11 |
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| 作者姓名： | 张倬 柯俊 王晟 庄建 陈寄梅 岑坚正 |
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| 作者单位： | 1. 武汉市第三医院胸心外科,武汉,430060
2. 广东省心血管病研究所,广东省人民医院,广东省医学科学院 |
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| 摘 要： | 目的:总结危重先天性心脏病(先心病)患儿新生儿期心内直视术的体外循环(CPB)管理经验.方法:对我院2009年度90例危重先心病患儿新生儿期行心内直视术的CPB情况进行回顾性总结分析.其中深低温停循环(DHCA)1例,深低温低流量(DHLF)结合下半身DHCA 2例,DHLF 43例,中度低温中低流量CPB 33例,浅低温中高流量CPB 5例,常温不停跳CPB 6例.2例术中给予平衡超滤 (ZBUF)结合常规超滤(CUF) 和改良超滤(MUF),其余均给予CUF联合MUF.结果:CPB转流时间37~380(118.9±66.5)min,主动脉阻断时间14~195(74.4±40.9)min.所有病例在开放主动脉后心脏均能自动复跳.86例成功脱离CPB.1例左心发育不良(HLHS)术后转为体外膜肺氧合支持160 h后死亡.本组死亡共13例,病死率14.4%.结论:接近生理的CPB预充,良好的心肌保护,选用适宜的灌注方式,合理的血气管理,联合运用各种超滤方法是确保危重先心病患儿新生儿期心内直视术成功的重要环节.
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| 关 键 词： | 先心病 新生儿 体外循环 |
Management of cardiopulmonary bypass during open heart surgery in critically ill neonates with complicated congenital heart disease |
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| ZHANG Zhuo,KE Jun,WANG Sheng,ZHUANG Jian,CHEN Jimei,CEN Jianzheng. Management of cardiopulmonary bypass during open heart surgery in critically ill neonates with complicated congenital heart disease[J]. Journal of Clinical Emergency Call, 2011, 12(1): 9-11 |
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| Authors: | ZHANG Zhuo KE Jun WANG Sheng ZHUANG Jian CHEN Jimei CEN Jianzheng |
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| Affiliation: | ZHANG Zhuo1 KE Jun2 WANG Sheng2 ZHUANG Jian2 CHEN Jimei2 CEN Jianzheng2 (1The Third Hospital of Wuhan,Wuhan,430060,China,2Guangdong Cardiovascular Institute,Guangdong General Hospital,Guangdong Academy of Medical Sciences) |
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| Abstract: | Objective:To summarize the experience of cardiopulmonary bypass during open heart surgery in neonates with complicated heart disease (CHD).Method:We reviewed the clinical data of cardiopulmonary bypass during open heart surgery in 90 neonates with CHD in 2009.The study included 1 with deep hypothermia circulatory arrest (DHCA),43 with deep hypothermia low flow (DHLF),2 with DHCA +DHLF,33 with moderate hypothermia bypass,5 with mild hypothermia and another 6 underwent NCPB with on-beating bypass.Zero-balance... |
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| Keywords: | complicated congenital heart disease neonate cardiopulmonary bypass |
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