小儿心血管麻醉与体外循环综合肺保护115例临床分析

ANALYSIS OF PULMONARY PROTECTION IN CHILD OPEN HEART SURGERY: A REPORT OF 115 CASES

目的总结小儿先天性心脏病心脏直视手术的麻醉与体外循环管理经验。方法回顾2000—2005年小儿心脏直视手术115例,对麻醉与体外循环管理中的肺保护措施进行分析。结果全组平均体外循环时间(77.6±50.3)min,主动脉阻断时间(48.5±36.1)min,ICU机械通气时间(14.3±8.9)h。术后X线胸片示肺部明显斑片状阴影7例(6.1%),未出现肺不张、低心排综合征等并发症,无死亡病例。结论小儿心脏直视手术中完善的麻醉与体外循环管理可以预防肺损伤、保护肺功能。

Objective To summarize the experience of anesthesia and cardiopulmonary bypass（CPB） during open heart surgery in children. Methods From 2000 to 2005, 115 children underwent open heart surgery with CPB in our department. This article reviewed the measures of pulmonary protection in the anesthesia and CPB. Results The time of CPB and aortic cross- clamping were （77. 6 ± 50.3）min and （48. 5 ± 36. 1）min respectively. The ventilation time was （14. 3 ± 8.9）h in ICU- In postoperative X- rays, 7 cases showed pulmonary complications, but the complications such as atelectasis and low cardiac output syndrome after operations did not occur, and no case died. Conclusion Perfect management of anesthesia and CPB during child open heart surgery is beneficial to pulmonary protection.