发绀型先天性心脏病患儿心脏手术围手术期脑损伤机制的研究进展

Study Progress of Mechanisms of Perioperative Cerebral Injury in Children with Cyanotic Congenital Heart Disease Undergoing Cardiac Surgery

小儿中枢神经系统发育不完善,先天性心脏病尤其是发绀型先天性心脏病(CCHD)会延缓神经系统的发育进程,导致中枢神经系统发育更加不完善甚至损伤,进而增加神经系统的脆弱性。体外循环下开胸心脏矫正术是根治CCHD患儿心脏问题的常用方法。CCHD患儿围手术期脑损伤的发病机制复杂,与慢性低氧相关的神经细胞损伤和脆弱性增加以及心脏手术、体外循环和低体温对机体的影响有关,并且围手术期脑损伤可显著增加CCHD患儿心脏术后的并发症和病死率。

The development of central nervous system is immature in children.The congenital heart disease especially cyanotic congential heart diease(CCHD)can delay the development of central nervous system and lead to more immature development and injury of central nervous system,and eventually increase the vulnerability of the nervous system.The surgery of open heart correction under cardiopulmonary bypass is a common radical method to treat heart problems in children with CCHD.Pathogenesis of perioperative brain injury in such surgeries is complicated,involving chronic hypoxia related neuronal impairment and vulnerability enhancement,and the effects of cardiac surgery,cardiopulmonary bypass and hypothermia on the body.And perioperative brain injury can significantly increase comorbidity and mortality of children after cardiac surgeries.