12kg以下小儿危重先天性心脏病的外科治疗

目的: 探讨12 kg以下低体重小儿危重先天性心脏病(先心病)外科治疗的手术时机、手术技术和围术期处理。方法: 回顾分析我院1999年5月~2004年10月手术纠治32例体重在12 kg以下危重先心病患儿临床资料。包括室间隔缺损伴肺动脉高压、法洛四联症、房间隔缺损伴肺动脉瓣狭窄、动脉导管未闭等。结果: 手术死亡2例,病死率6.3%,其余均治愈出院。术后平均机械通气(18±8.6) h,平均重症监护(4.5±1.5)天。随访2个月~2年,生存患儿心功能显著改善,生长发育明显加快。结论: 随着小儿心脏外科技术的发展和完善,低体重危重先心病患儿的外科治疗是安全、可行的。

Surgical treatment of critical congenital heart defect in infants under 12 kg

Objective: To discuss the indication,technique and preoperative management of low weight infants with critical congenital heart defects.Methods: The clinical data of 32 infants under 12 kg undergoing cardiac operation from May 1999 to October 2004 in our hospital were reviewed retrospectively.The symptoms included ventricular septal defect with pulmonary hypertension,tetralogy of Fallot,atrial septal defect with pulmonary stenosis and patent ductus arteriosus.Results: Two cases died after operation and the hospital mortality was 6.3%.The average duration of mechanical ventilation was (18±8.6) hours and the average ICU stay was (4.5±1.5) days.The follow-up lasted for 2 to 24 months.The cardiac function of the patients improved greatly and the growth approximated the normal.Conclusions: With the development of pediatric heart surgery,cardiac operation on infants with low weight and critical congenital heart defects is safe and feasible.