双向腔静脉肺动脉吻合术的麻醉处理

Anesthetic management of bidirectional cavopuimonary anastomosis

对10例双向腔静脉肺动脉吻合术(BCPA)的麻醉处理进行了分析。患儿均为紫绀型复杂先天性心脏病。麻醉选择以大剂量芬太尼为主,复合吸入低浓度安氟醚,根据不同情况采用深低温低流量、深低温停循环或并行循环等体外循环方法,术中加强麻醉监测和管理。结果全组病人麻醉平稳,术中血流动力学稳定,术后死亡1例,9例存活者无任何麻醉并发症。体会:要取得良好的临床效果,需要包括外科、麻醉、灌注等各方面整体水平的提高,才能减少并发症和提高存活率。

Ten paediatric patients with complex cyanotic congenital heart disease,undergoing bidirectional cavopulmonary anastomosis (BCPA) were analysed for their anesthetic management. Anesthesia was maintained with introvenous high dose of fentanyl,combined with inhalation of low concentration of enflurane. The methods of deep hypothermic circulatory arrest,deep hypothermic low flow and supplemental circulation during cardiopulmonary bypass were used in according to different conditions. Intraoperative anesthetic management and cardiac monitoring were carefully performed. The results showed that anesthetic management and hemodynamics of all patients were stable during operation. No anesthetic death and complications occured in this group of patients. So meticulous preoperative preparation,satisfactory anesthesia,precise surgical and perfusion techniques are necessary to improve the clinical results.