小儿先天性心脏病介入术中高危因素与麻醉管理(附2645例分析)

HIGH RISK FACTORS AND ANESTHESIA MANAGEMENT OF PEDIATRIC CARDIAC CATHETERIZATION IN CHILDREN WITH CONGENITAL HEART DISEASES(ANALYSIS OF 2645 CASES)

目的分析儿童先天性心脏病心脏导管检查造影和介入治疗术中并发症的发生率、原因、多种高危因素,总结麻醉经验。方法对2 645例接受心导管检查和介入治疗的先天性心脏病儿童术中并发症进行回顾性分析,对211例并发症按其高危风险程度归纳总结,分为主要并发症、次要并发症、一般风险事件。结果全部并发症总发病率为8.0%,主要并发症71例,次要并发症67例,一般风险事件73例,死亡3例,病死率为0.11%;并发症发病率球囊扩张组为12.6%,检查造影组为9.0%,均远高于封堵组的4.1%,同时也高于总的发生率8.0%;全组并发症小于1岁的发生率为16.6%,大于1岁的发生率为6.3%。结论儿童先天性心脏病介入术中高危事件发生率高于一般小儿麻醉手术,小于1岁的术中风险加大,球囊扩张组风险要高于封堵组。选择适合的麻醉方法、麻醉药物、有效的监测和正确的麻醉管理可减少先天性心脏病介入治疗术中的并发症。

Objective To review the complication diagnostic catheterization and cardiac interventional cathet heart disease,and analyze various kinds of high factors and Methods Two thousand six hundred and forty-five cases of retrospectively analyzed. Two hundred and eleven cases of classified into major complications, minor complicatio risk. Results The overall complication rate was 8 including three deaths, 67 minor complications and 0.11%. The complication rate for balloon dilatation rates and causes during pediatric erization in children with congenital summarize experience of anesthesia. pediatric cardiac catheterization were complications were summarized and ns,or incidents according to the degrees of 8.0%, there were 71 major complications 73 other incidents, the mortality rate was catheterization was 12.6% and 9.0% for solely diagnostic cardiac catheterization,which was higher than 4. 1 % for occlusion catheterization and 8.0% for all cases. The incidence rate in infants under 1 year old was 16.6% and 6.3% for those children over 1 year old. Conclusion High risk events occur more commonly during cardiac catheterization than during general pediatric anesthesia. Cases with higher risk are those under 1 year old. The incidence rate of complication for balloon dilatation catheterization is higher than occlusion catheterization. The severe complication can be decreased by choosing a suitable anesthesia method and drugs,effective supervision and accurate anesthesic management.