PICU儿童先天性心脏病心导管术后并发症及处理(附69例分析)

目的总结我院7年来先天性心脏病(先心病)心导管术患儿,需入重症监护病房(PICU)治疗的严重并发症的类型及处理方法。方法回顾性分析入PICU治疗的69例患儿并发症类型、发生率、死亡原因及防治等。结果需入PICU的先心病患儿心导管术并发症包括麻醉后呼吸抑制及呼吸道分泌物增加、肺瘀血、术中心率下降、严重心功能不全和/或低血压或肺水肿、严重心律失常、介入治疗后心包积液、缺氧发作、麻醉后低血压、造影剂过敏等。并发症发生率为1.5%。入住PICU时间为30.5 h,呼吸机使用时间为26.9 h。死亡4例。结论对于不同类型并发症采取不同的处理方法,减少心导管术后严重并发症的病死率。

The significant cardiac catheterization complications and its managements in children with congenital heart diseases in PICU

Objective To describe the cardiac catheterization complications types and its managements in congenital heart diseases in PICU.Methods We retrospectively analyzed the cardiac catheterization complication types,incidence,death causes and managements of the 69 congenital heart drseases cases.Results The cardiac catheterization complications included respiratory depression and increased respiratory secretion,pulmonary venous stasis,heart rate dropping during operation,severe cardiac dysfunction and/or hypotension or pulmonary edema,severe arrhythmia,pericardial effusion after interventional catheterization,anoxia,hypotension after anaesthesia,allergy to angiography agent.The incidence was 1.5%.The mean interval was 30.5 hours in PICU,26.9 hours in mechanical ventilation.Four cases died of heart failure and pericardial effusion.Conclusion The incidence of cardiac catheterization complications in children congenital heart diseases in PICU is very low.The first three complications were respiratory disease,heart disease and anoxia.We should deal with the complications according to the types and severity.