主动脉弓中断矫治术后监护要点

Postoperative Care for one-stage repair of interrupted aortic arch(IAA)

目的总结和探讨主动脉弓中断术后监护要点。方法对1995年1月-2008年3月实行的8例次主动脉弓中断一期矫治患儿进行回顾性分析。8例患儿中，男性5例，女性3例，手术年龄1～11岁，体重9～21kg。其中A型血7例，B型血1例，8例均合并其他心血管畸形和重度肺动脉高压。结果全组死亡1例，死于术后严重低心排综合征及肾功能衰竭，随访7例，6～12年，无晚期死亡，心功能NYHA工级。结论围绕患儿手术前后病理生理改变的特点、血管通畅程度、心、肺、肾功能状况，展开针对性、个体化性监护，可减少术后并发症的发生率，提高术后生存率。

Objective To discuss and review the postoperative care and experience with one-stage repair of interrupted aortic arch（IAA）. Methods Since January 1995 to March 2008, 8 cases （male 5, female 3） with IAA were operated. The operative age was 1-11 years and body weight was 9-21 kg, 7 patients were tape A and 1 patient were type B. ALL patients had associated cardiac anomalies and severe pulmonary hypertension. Results There were one early death as a result of severe low cardiac output syndrome combined with acute renal failure. The 7 survivors were followed up from 0.5-12 years, there was no late death. Their cardiac function was NYHA I . Conclusion The postoperative mortality complications of interrupted aortic arch can be reduced by intensive care and homodynamic states changes after operation.