Background:Parents of children with complex right ventricular outflow tract(RVOT)anomalies are confronted with their child’s need for heart surgery early in life and repeated reoperations later on.Preoperative assess...Background:Parents of children with complex right ventricular outflow tract(RVOT)anomalies are confronted with their child’s need for heart surgery early in life and repeated reoperations later on.Preoperative assessment needs to be performed whenever an indication for reoperation is suspected.The aim was to illuminate the experiences of parents of children diagnosed with RVOT anomalies,in particular,how they experience their child’s heart disease and everyday life during the assessment and after the decision on whether to perform a reoperation.Method:Individual interviews(n=27)were conducted with nine parents on three occasions between 2014 and 2016 and analyzed using reflexive thematic analysis.Results:The analysis resulted in the following five main coexisting themes:The heart surgery keeps my child alive illuminates parents’experiences during and after the assessment and emphasizes that heart surgery,although dreaded,is central for their child’s survival;Everyday struggles illuminates the different struggles parents had to face to ensure that their child would be in the best possible condition;the remaining three themes,Unconditional love,Trust in life,and Togetherness,illuminate the ways in which the parents gained inner strength and confidence in their everyday lives.Conclusion:Although the parents were grateful for the assessment and had learned to navigate among the fears it aroused,they experienced several distressing situations during the assessment process that should be addressed.By inviting both the parents and their child to participate in the child’s care,individualized support can take into account the needs of both parents and child.展开更多
目的探讨微创切口联合腹腔镜同期治疗先天性心脏病合并心外畸形安全性及可行性。方法选取2015年11月至2023年4月于首都儿科研究所附属儿童医院心脏外科收治的24例采用微创切口联合腹腔镜同期治疗先天性心脏病合并心外畸形患儿(微创联合...目的探讨微创切口联合腹腔镜同期治疗先天性心脏病合并心外畸形安全性及可行性。方法选取2015年11月至2023年4月于首都儿科研究所附属儿童医院心脏外科收治的24例采用微创切口联合腹腔镜同期治疗先天性心脏病合并心外畸形患儿(微创联合组),以及年龄、体重、心脏畸形、手术方式、心功能及麻醉ASA分级相匹配的24例单纯先天性心脏病患儿(单纯先心病组)作为研究对象。统计分析两组患儿术中、术后等临床指标差异性。结果微创联合组患儿均成功施行联合手术,术后无明显并发症,两组患儿均成功治愈出院;与单纯先心病组相比,微创联合组患儿麻醉时间及手术时间明显延长,手术费用明显增多,差异有统计学意义(P<0.05),但体外循环时间、主动脉阻断时间、术中出血量,术后气管插管时间、CICU时间、住院时间、麻醉费用、住院费用等指标差异无统计学意义(P>0.05);微创联合组与单纯先心病组术后早期血流动力学指标比较,术后8 h CCE明显高于单纯先心病组(P<0.05),其余术后各时点CCE差异无统计学意义;两组CI、dp/dt、Glu、Lac、IS指标在术后0、4、8、12、16、20、24 h差异均无统计学意义(P>0.05)。结论微创切口联合腹腔镜同期治疗先天性心脏病合并非心脏畸形安全可行,同时具有切口美观的优点,值得临床推广。展开更多
基金This study was supported by the Pediatric Heart Center at Skåne University Hospital Lund and Lund University,and by the Swedish Children’s Heart Association.
文摘Background:Parents of children with complex right ventricular outflow tract(RVOT)anomalies are confronted with their child’s need for heart surgery early in life and repeated reoperations later on.Preoperative assessment needs to be performed whenever an indication for reoperation is suspected.The aim was to illuminate the experiences of parents of children diagnosed with RVOT anomalies,in particular,how they experience their child’s heart disease and everyday life during the assessment and after the decision on whether to perform a reoperation.Method:Individual interviews(n=27)were conducted with nine parents on three occasions between 2014 and 2016 and analyzed using reflexive thematic analysis.Results:The analysis resulted in the following five main coexisting themes:The heart surgery keeps my child alive illuminates parents’experiences during and after the assessment and emphasizes that heart surgery,although dreaded,is central for their child’s survival;Everyday struggles illuminates the different struggles parents had to face to ensure that their child would be in the best possible condition;the remaining three themes,Unconditional love,Trust in life,and Togetherness,illuminate the ways in which the parents gained inner strength and confidence in their everyday lives.Conclusion:Although the parents were grateful for the assessment and had learned to navigate among the fears it aroused,they experienced several distressing situations during the assessment process that should be addressed.By inviting both the parents and their child to participate in the child’s care,individualized support can take into account the needs of both parents and child.
文摘目的探讨微创切口联合腹腔镜同期治疗先天性心脏病合并心外畸形安全性及可行性。方法选取2015年11月至2023年4月于首都儿科研究所附属儿童医院心脏外科收治的24例采用微创切口联合腹腔镜同期治疗先天性心脏病合并心外畸形患儿(微创联合组),以及年龄、体重、心脏畸形、手术方式、心功能及麻醉ASA分级相匹配的24例单纯先天性心脏病患儿(单纯先心病组)作为研究对象。统计分析两组患儿术中、术后等临床指标差异性。结果微创联合组患儿均成功施行联合手术,术后无明显并发症,两组患儿均成功治愈出院;与单纯先心病组相比,微创联合组患儿麻醉时间及手术时间明显延长,手术费用明显增多,差异有统计学意义(P<0.05),但体外循环时间、主动脉阻断时间、术中出血量,术后气管插管时间、CICU时间、住院时间、麻醉费用、住院费用等指标差异无统计学意义(P>0.05);微创联合组与单纯先心病组术后早期血流动力学指标比较,术后8 h CCE明显高于单纯先心病组(P<0.05),其余术后各时点CCE差异无统计学意义;两组CI、dp/dt、Glu、Lac、IS指标在术后0、4、8、12、16、20、24 h差异均无统计学意义(P>0.05)。结论微创切口联合腹腔镜同期治疗先天性心脏病合并非心脏畸形安全可行,同时具有切口美观的优点,值得临床推广。
