河北医科大学学报 ›› 2024, Vol. 44 ›› Issue (5): 519-523.doi: 10.3969/j.issn.1007-3205.2024.05.005

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≤10 kg婴幼儿先天性心脏病的围手术期治疗

  

  1. 河北医科大学第一医院心外科ICU,河北 石家庄 050031

  • 出版日期:2024-05-25 发布日期:2024-05-22
  • 作者简介:吕瑛(1979-),女,山西阳泉人,河北医科大学第一医院副主任医师,医学硕士,从事心血管疾病危重症管理研究。
  • 基金资助:
    河北省医学科学研究重点课题计划(20180244)

Perioperative treatment of congenital heart disease in infants and young children weighing less than 10 kg

  1. Department of Cardiac Surgery, the First Hospital of Hebei Medical University, Shijiazhuang 050031, China

  • Online:2024-05-25 Published:2024-05-22

摘要: 目的 评估低体重(≤10 kg)婴幼儿先心病的外科手术效果,总结临床经验。
方法 回顾性分析心外科低体重(≤10 kg)婴幼儿先心病1 382例的临床资料。男性665例,女性717例;年龄6 d~3岁,平均(9.58±1.84)个月;体重1.6~10.0 kg,平均(8.82±1.13) kg。其中1 305例在全身麻醉下行心脏畸形根治术,77例行姑息手术。
结果 全组手术顺利,术后死亡13例,占0.94%。死亡原因:低心排综合征7例,恶性心律失常1例,低氧血症5例(其中严重肺部感染2例)。
结论 低体重婴幼儿先心病的外科手术治疗是安全可行且有价值的,临床效果肯定,但必须正确掌握手术时机,缩短手术时间,严格进行围手术期管理,提高手术疗效。


关键词: 心脏病, 婴儿, 出生时低体重, 外科手术

Abstract: Objective To evaluate the surgical effect of congenital heart disease (CHD) in infants and young children with low body weight (≤10 kg), and to summarize the clinical experience. 
Methods The clinical data of 1 382 infants and young children with CHD and low body weight (≤10 kg) in Department of Cardiac Surgery were retrospectively analyzed. There were 665 males and 717 females, and the age ranged from 6 days to 3 years, with a mean of (9.58±1.84) months; The average body weight was (8.82±1.13) kg. Of all patients, 1 305 patients underwent radical resection of heart malformations under general anesthesia, and 77 patients underwent palliative surgery. 
Results The operation was successful in the whole group, and 13 cases died after operation, accounting for 0.94%. The causes of death included low cardiac output syndrome in 7 cases, malignant arrhythmia in 1 case, hypoxemia in 5 cases (including severe pulmonary infection in 2 cases). 
Conclusion Surgical treatment is safe, feasible and valuable for CHD infants and youny children with low body weight, suggesting good clinical effect. However, it is necessary to correctly control the timing of the surgery, shorten the duration of operation, strictly manage the perioperative period, and improve the surgical efficacy.


Key words: heart diseases, infant, low birth weight, surgical procedures