经导管介入小儿先天性冠状动脉瘘堵闭术的麻醉管理

ANESTHESIA MANAGEMENT FOR TRANSCATHETER CLOSURE OF CONGENITAL CORONARY ARTERY FISTULA IN CHILDREN

目的探讨经导管介入小儿先天性冠状动脉瘘堵闭术的麻醉管理方法。方法 2010年6月～2012年6月,接受心导管介入治疗先天性冠状动脉瘘的小儿11例,ASA评级Ⅰ～Ⅱ级,术中均以氯胺酮复合异丙酚静脉维持全身麻醉。结果 10例患儿术中保留自主呼吸,手术麻醉过程顺利。1例患儿术中缺氧发作,同时伴有心电图ST段改变,遂停止治疗。结论术前给予充分病情评估,术中严密监测患儿生命体征及心电图变化,采用氯胺酮复合异丙酚静脉全身麻醉下行经导管介入治疗冠状动脉瘘能满足手术要求,且具有创伤小、术后麻醉并发症少的优点。

Objective To investigate the anesthetic management for transcatheter closure of congenital coro nary artery fistula （CAF） in children. Methods Eleven children with CAF of Alnerican Society of Anesthesiologists physical status（ASA） Ⅰ～Ⅱ ,received transcatheter closure from June,2010 to June,2012. All cases received continuous intravenous Ketamine and Propofol intraoperatively. Results Ten children kept spontaneous respiration with a successful anesthesia. But one case ceased for intraoperative hypoxia with ST segment changed in electrocardiogram （ECG）. Conclusion A full condition assessment preoperatively,vital signs together with ECG monitoring and intravenous anesthesia with Ketamine - Propofol during transcatheter closure for CAF, meet the surgical intraoperative requirements well in children.