婴幼儿先心病合并肺动脉高压围术期呼吸道管理

目的　总结与分析我院近年来 2 6例婴幼儿先心病合并肺动脉高压病人围手术期呼吸道管理情况 ,以提高外科治疗效果。方法　术前常规准备 ,同时氧疗 ,术中常规应用血管扩张剂硝普钠 ,术后保持呼吸道通畅 ,应用呼气末正压 (PEEP) ,适当延长插管时间 ,严格拔管指征 ;同时静脉应用硝普钠。结果　全组 2 6例 ,2 3例治愈出院 ,3例死亡 ,占 11.5 4% ,死亡原因为术后低心排 ,呼吸衰竭。结论　术后正确选用呼吸机 ,合理调整各种参数 ,加强呼吸道管理 ,可以获得理想的治疗效果。

The Respiratory Tract Management of Infants with Congenital Heart Disease and Pulmonary Hypertension during Perioperation

To analyze and conclude the circumstances of perioperative respiratory tract management to 26 infant patients with congenital heart disease and pulmonary hypertension. Methods All the patients got a routine preoperative preparation with an oxygen therapy at the same time and then were given vasodilator such as sodium nitroprusside during operation. Not only the respiratory tracts were kept unobstructed, but positive end expiratory pressure (PEEP) was used as well after operation. The cannulas were placed for suitably longer time, and pulled out strictly according to the indications. Sodium nitroprusside was administered intravenously. Results There were 23 patients (88.46%) were cured in this group and the other three died resulting from postoperative low cardiac output and respiratory failure. Conclusion Most of the infant patients with congenital heart disease and pulmonary hypertension can be cured if respirator is chosen correctly and parameters are adjusted appropriately and respiratory tract management is strengthened.