先天性心脏病婴幼儿心内直视手术的呼吸系统罹患病情分析

Respiratory Morbidity of Infants Congenital Heart Disease After Direct-view Intra-cardiac Surgery

目的了解运用体外循环心内直视手术治疗婴幼儿先天性心脏病术中、术后、解除呼吸机后的呼吸系统罹患情况。方法分析55例婴幼儿体外循环心内直视手术患儿的临床资料,其中男31例,女24例,平均年龄(19.7±8.6)月,平均体重(10.8±2.3)kg。年龄分布是:<1岁18例,<2岁21例,<3岁16例。结果55例婴幼儿术中术后呼吸系统罹患共17例(占30.9%),其中呼吸衰竭6例,肺不张6例,严重肺部感染3例,液气胸2例,死亡4例。<1岁婴儿呼吸系统罹患率、死亡率均高于其他两个年龄段。结论婴幼儿体外循环心内直视手术治疗先天性心脏病的呼吸系统罹患率正在逐步低龄化(<1岁),并且术中、术后注意在保护心肌的同时还要注意呼吸系统并发症主要是呼吸衰竭和肺不张的处理。

Objective To review the respiratory morbidity of intraoperative, postoperative and respirator- relief periods among congenital heart defect infants received extracorporeal circulation intra - cardiac direct - view surgery. Methods The clinical data of 55 infant extracorporeal circulation intra - cardiac direct - view surgeries were evaluated; among them, 31 males and 24 females, the average age was 19.7 ± 8.6 months, and the average weight was 10.8 ± 2.3kg. The age distribution was 18 cases less than 1 year - old, 21 cases less than 2 year- old, and 16 cases less than 3 year - old. Results Among the 55 cases, 17 infants were affected by respiratory infection during and after the surgery （30.9%）; among them 6 were suffered form respiratory failure, 6 from atelectasis, 3 from severe pulmonary infection, and 2 from hydropneumothorax; and 4 cases were died. The morbidity and mortality of infants less than l year- old were higher than the other two age groups. Conclusion The respiratory morbidity of infant extracorporeal circulation intra - cardiac directview surgery in correction of congenital heart disease is prevalently existed in the low age group （ less than l year - old）, and the clinicians should pay more attention to protect the cardiac muscle and the respiratory system concurrent syndrome during and after the surgical procedure, especially in respiratory failure and atelectasis.