全麻与局麻方式下先天性心脏病患儿介入治疗中辐射剂量对比

Comparative study of radiation dose in interventional therapy for children with congenital heart disease under general anesthesia and local anesthesia

目的:探讨全麻与局麻对小儿先天性心脏病(CHD)介入治疗中辐射剂量的影响。方法:回顾性分析医院2012年至2017年进行介入治疗的CHD患儿80例,根据麻醉方式不同,分为局麻组(n=40)与全麻组(n=40)。应用数字减影血管造影(DSA)设备,使用浓度为320 mg I/mL的非离子型造影剂碘克沙醇,由相同术者对两组患儿完成手术,对比两组患儿的体表峰值剂量(PSD)、剂量面积乘积(DAP)、累积剂量(CD)、透视时间(FT)等辐射剂量指标及并发症发生情况。结果:全麻组的PSD、DAP、CD、FT均小于局麻组(P<0.05);并发症总发生率比较,全麻组小于局麻组,差异有统计学意义(P<0.05)。结论:CHD患儿在介入手术治疗中,麻醉方式应用全麻相较于局麻,患儿受到辐射剂量小,并发症发生率低,安全性更高。

Objective: To investigate the effect of general anesthesia and local anesthesia on radiation dose in interventional therapy for children with congenital heart disease (CHD). Methods: A retrospective analysis was performed on 80 patients with CHD who underwent interventional therapy in the hospital from 2012 to 2017. They were divided into local anesthesia group ( n =40) and general anesthesia group ( n =40) according to different anesthesia methods. Digital subtraction angiography (DSA) equipment and the non-ionic contrast agent iodixanol at a concentration of 320 mg I/m L were used. The operation for both groups was operated by the same doctors. Radiation dose indicators such as peak surface dose (PSD), dose-area product (DAP), cumulative dose (CD) and fluoroscopy time (FT) and incidence of complications were compared between the two groups. Results: The PSD, DAP, CD and FT in the general anesthesia group were smaller than those in the local anesthesia group ( P <0.05). The total incidence of complications in the general anesthesia group was lower than that in the local anesthesia group ( P <0.05). Conclusion: In interventional therapy for children with CHD, compared with local anesthesia, general anesthesia can decrease the radiation dose, and the incidence of complications is lower, with higher safety.