婴幼儿先天性心脏病心导管术中呼吸系统严重并发症的X线诊断及处理

X-ray diagnosis and treatment for severe respiratory complications during cardiac catheterizations on pediatric congenital heart disease

目的研究婴幼儿先天性心脏病心导管术中呼吸系统严重并发症的X线表现特点,为早期正确诊断和及时处理提供理论依据。方法回顾性分析9例心导管术中呼吸系统严重并发症的临床特点、X线表现及治疗措施。结果9例中7例发生严重的低氧血症,其中6例出现心率减慢。X线表现为两肺野透亮度降低7例,急性肺水肿1例,右上肺不张1例。经紧急处理,除肺水肿1例死亡,余病例均恢复。结论婴幼儿先天性心脏病导管术中呼吸系统严重并发症病情危急,X线表现多样,正确识别、早期诊断和治疗是抢救成功的关键。

Objective To study the radiological features of severe respiratory complications during cardiac catheterizations on pediatric congenital heart disease so as to make early diagnosis and treatment. We also intend to find the mechanism of these complications. Methods A total of 9 pediatric cases with severe respiratory complications during cardiac catheterizations were included in the study. The clinical manifestations, radiological features, and corresponding treatments were reviewed. Results Most of the cases had severe hypoxia, with 6 cases presenting with bradycardia. Opacification of two lung fields was found in 7 cases, pulmonary edema in 1 case, and atelectasis of the upper right lung in 1 case. With intubation, oxygen inhalation and administration of certain drugs, all cases were saved except 1 case with pulmonary edema. Conclusion Severe respiratory complications during cardiac catheterizations on pediatric congenital heart disease are emergent and critical, and they often presented with various manifestations. Early diagnosis and correct treatment are the key to successful salvage.