10kg以下婴幼儿法乐四联症根治术的体外循环管理

Extracorporeal circulation management in radical correction of tetralogy of Fallot in infants below 10 kg

目的系统性回顾总结我院2009～2011年48例10 kg以下婴幼儿法乐四联症(TOF)根治术的体外循环(ECC)管理。方法本组48例TOF患儿中,男26例,女22例。年龄6～30个月,体重3.5～10 kg,均经超声心电图和心脏导管造影检查确诊,均在ECC下进行根治性手术。48例均采用进口膜式氧合器(MAQUET 30 000或10 000),体外循环时间50～166 min,阻断主动脉时间27～94 min。结果 48例患儿均顺利脱机,术后死亡3例,死亡与ECC技术无关;余45例痊愈出院。结论低龄、低体重TOF患儿根治术的ECC应力求平稳,ECC中积极完善预充方案和改进体外循环方法,是减少术后并发症的关键。

Objective To summarize the extracorporeal circulation （ECC） management in the radical correction of tetralogy of Fallot （TOF） in 48 infants below 10 kg in our hospital from 2009 to 2011. Methods In the 48 cases of TOF, there were 26 male ones and 22 female ones who were aged from 6 to 30 months with the weight of 3.5 - 10 kg. They all were diagnosed as TOF by UCG and cardiac catheter visualization and received the total correction under ECC. In the 48 cases, imported membrane oxygenation apparatus （MAQUET 30,000 or 10,000） was used. The ECC time was 50 - 166 min, and the aorta - blocking time was 27 - 94 min. Results All cases received extubation successfully. Three ones died after the operation and their death causes were not related to the ECC technique. The other 45 ones recovered and discharged successfully. Conclusion ECC of correction for young - aged and low - weighted infants with TOF should be stable. Positive improvements in pre - filling schedule and ECC method are keys to reduce the postoperative complications.