婴幼儿法乐氏四联症根治术围术期处理

Perioperative Management of Infants and Young Children with Tetralogy of Fallot

对 4 2例体重 4 .2～ 14kg,3～ 36个月龄的法乐氏四联症患儿 ,在低温体外循环下行法四根治术。术后使用多巴胺、多巴酚丁胺 2～ 10 μg/(kg.min)。末梢循环欠佳或低心排时用硝普钠 0 .1～ 0 .5μg/(kg.min)。尿量偏少用速尿效果欠佳时加用硝酸甘油。合理搭配胶体液和晶体液的用量 ,控制出入量。结果 :术后出现低心排 5例 ,死亡 3例 ,39例康复出院。认为术前加强营养 ,提高血氧饱和度 ,能提高患儿对手术的耐受力。术后用多巴胺和多巴酚丁胺能改善心功能 ,稳定血压。

patients with tetralogy of Fallot in infants and young children(ages:3～36 months old and weights:4 2～14kg) underwent total correction of tetralogy of Fallot under deep hypothermia and cardiopulmonary bypass In postoperative management,dopamine and dobutamine at the speed of 2～10μ g/(kg min) were administrated,sodium nitroprusside at the speed of 0 1～0 5μ g (kg min) when low cardiac output states were complicated Furosemide was used when urine decreased,nitroglycerin was also used according urine Postoperative fluid administration should be precise according the intake and output fluid volumes 5 patients were complicated low cardiac output states,3 patients died 39 patients recovering conclusion Adequate nutrition and higher blood oxygen levels in preoperation can increase the operative tolerance The use of dopamine and dobutamine postoperation can improve cardiac function and stabilize blood pressure