开胸抢救小儿体外循环心内直视手术后心搏循环骤停

Open chest rescue for sudden arrest of heart and circulation in children undergone heart surgery.

目的探讨小儿先天性心脏病术后心脏压塞及心跳循环骤停的起因、治疗和疗效。方法床边开胸抢救１８例心内直视手术后心脏压塞及心博循环骤停患儿。其中出血性心脏压塞７例，非出血性心脏压塞６例，血容量不足２例，心律失常３例。１４／１８例发生于术后４ｈ内。结果初级复苏全部成功，１５例存活病儿无并发症，３例于复苏后２ｄ内死于顽固性心功能不全。结论小儿心内直视手术后出现心脏压塞及心搏循环骤停立即床边开胸抢救可获得满意疗效。

Objective To evaluate the causes, treatment and outcome of cardiac tamponade or compression and heart beat arrest after open heart surgery in children. Methods Eighteen cases of cardiac tamponade or compression and heart beat arrest underwent open chest treatment at bedside in ICU. Cardiac tamponade caused by bleeding was found in 7, nonbleeding cardiac compression in 6, acute blood volume reduction in 2,and heart beat arrest due to arrhythmia in 3. Cardiac tamponade and heart beat arrest in 14 patients occurred within 4 hours postoperation.Results The initial stage of resuscitation in all cases was successful. Fifteen survivors were well recovered without any complication. Three patients died of uncontrollable heart failure. Conclusions The satisfactory result may be obtained by the bedside open chest emergency treatment of cardiac tamponade, compression or cardiac arrest after cardiac operation.