婴幼儿先天性心脏病伴肺动脉高压术后机械通气的策略

目的 探讨婴幼儿先天性心脏病伴肺动脉高压术后机械通气的策略,研究如何让婴幼儿患者在长时间机械通气的情况下减少呼吸道并发症,并尽快撤离呼吸机.方法 对本院2005年1月至2011年6月实施的748例先天性心脏病伴肺动脉高压患儿术后机械通气监护方法进行分析总结.结果 本组748例患儿,呼吸机辅助时间为4～ 964 h,平均时间(28.1±1.7)h,拔管后21例患儿出现较明显的呼吸困难,再插管17例,3次插管1例,用鼻塞气道正压通气(CPAP)4例,患儿呼吸困难症状得以改善.胸片提示肺不张5例,气胸6例,死亡12例.结论 术后机械通气期间,通过合理的呼吸机调整,有效的呼吸道保护及营养支持等方法可减少呼吸机相关并发症并缩短机械通气的时间.

Infants with congenital heart disease accompanied pulmonary hypertension in strategy of postope rative mechanical ventilation

Objective To explore the postoperative mechanical ventilation strategies on infants with congenital heart disease accompanied with pulmonary hyperfension,study how to reduce respiratory tract complications and remove respirator ASAP.Methods To analyze and summarize postoperative mechanical ventilation monitoning methods carried out on 748 infants with congenital heart disease accompanied with pulmonary hypertension treated in our hospital from Jan.2005 to June 2011.Results Among 748 infants,the respirator assisting time is from 4 to 964 hours(28.1±1.7)h.After removing the respirator,obvious dyspnea was appeevned in 21 infants.The respirator was used again on 17 infants and for the third time on 1.4 were treated with CPAP.Dyspnea was then relieved.X-ray sternum indicate of 5 atelectases,6 peneumothoraxes and 12 deaths.Conclusion During mechanical ventilation,the relative complications can be reduced and ventilation time can be shortened by reasonable respirator adjustment,effective respiratory tract protection and nutritional support.