唐氏综合征合并先天性心脏病外科治疗的临床分析

Surgical treatment of Down syndrome with congenital heart disease

目的总结唐氏综合征合并先天性心脏病患儿的手术治疗的临床资料,探讨治疗效果。方法对比分析2013年2月—2018年2月在深圳大学总医院胸心外科接受手术治疗的唐氏综合征合并先天性心脏病患儿39例,对比分析所有患儿的体外循环手术数据,讨论其手术效果。结果所有39例患儿均顺利停机,体外循环时间52~166(66.5±8.3)min,主动脉阻断时间32~110(43.5±6.9)min;全组无手术死亡,手术成功率100%;术后呼吸机辅助时间12~96(18.0±2.1)h;重症监护时间48~120(66.0±5.6)h;住院时间10~15(12.0±1.8)d;39例患儿均成功治愈出院。结论唐氏综合征合并先天性心脏病患儿易出现早期肺动脉高压,需早期诊断和手术,手术效果良好,手术风险无明显增加,围术期需要重点防范由于智力障碍引发的躁动等问题。

Objective To harvest the clinical data of surgical treatment of Down syndrome patients complicated with congenital heart disease,and to explore the therapeutic effect.Methods Thirty-nine children with Down syndrome and congenital heart disease who had been treated surgically between February 2013 and February 2018 were selected,Objective to compare and analyze the data of cardiopulmonary bypass(CPB)in all children,and discuss the operation effect.Results All the 39 patients were weaned off cardiopulmonary bypass once.The extracorporeal circulation lasted 52-166(66.5±8.3)min,and the duration of aortic occlusion was 32-110(43.5±6.9)min.There was no surgical death in the whole group,and the success rate of surgery was 100%.Postoperative ventilator assistance lasted 12-96(18.0±2.1)hours,intensive care 48-120(66.0±5.6)hours and hospital stay was 10-15(12.0±1.8)days.All these patients were cured and discharged.Conclusion Children with Down syndrome and congenital heart disease are susceptible to early pulmonary hypertension and require early diagnosis and surgery.The surgical effect is good and the risk of surgery is not significantly increased.Perioperative prevention of restlessness caused by mental retardation is critical.