婴幼儿法乐四联症的麻醉处理

The Anesthetic Management of Infants With Tetralogy of Fallot

目的：根据法乐四联症所导致的特殊的血流动力学改变及全身异常的生理变化，探讨更适当的麻醉方法。方法：回顾性总结１９９１年以来３００例婴幼儿法乐四联症患儿的血流动力学、血气、并发症及死亡率。结果：血流动力学及血气分析结果均较稳定。死亡１１例（占３．７％），其中严重低输出量综合征４例，肺部并发症５例，ＩＩ度房室传导阻滞１例，肾功能衰竭１例。结论：针对术前缺氧、易脱水、酸血症等改变，作相应处理，密切监测血氧饱和度，防治转流前缺氧发作及低血压，是保证麻醉平稳的关键。

Objective:To go further into the appropriate anesthetic procedures for infants with tetralogy of Fallot according to their characteristic hemodynamic alternations and abnormal physiological changes. Methods:To sum up the changes of hemodynamics and blood gases as well as the postoperative complications and mortality of 300 infants with tetralogy of Fallot since 1991. Results:The results of the hemodynamics and the blood gases were all stable.There were 11(3 7%)postoperative deaths,including 4 of serious low output syndrome,5 pulmonary complications,and 1 complete atrioventicular block and 1 acute renal failure. Conclusions:To conduct corresponding management to preoperative hypoxemia,dehydration or metabolic acidosis,pay close attention to SPO 2 and prevent the onset of hypoxemia and hypotension before CPB are key points to enable a smooth anesthetic course.