CAJ | 학술논문

目的探讨先天性心脏病(CHD)伴重度肺动脉高压(PH)体外循环(CPB)术后早期并发症及处理.方法对本科2003年6月至2009年6月行CPB手术的45例CHD伴重度PH患者进行回顾分析,讨论术后早期主要并发症和死亡原因.结果术后早期主要并发症有严重低氧血症(13.33%)、缺氧发作(11.11%)、低心排(6.67%).住院死亡率6.67%,死亡原因均为低心排,主要为右心室功能失代偿.多因素分析显示,低温CPB(OR=0.56;95%CI 0.35-0.89)是严重低氧血症的一个危险因素.结论术后早期并发症主要由术后PH为基础的心肺功能不全所导致,对术后高危患者动态监测肺动脉压、右心功能和延长呼吸机支持,有助于防治并发症.
목적 탐토선천성심장병(CHD)반중도폐동맥고압(PH)체외순배(CPB)술후조기병발증급처리.방법 대본과2003년6월지2009년6월행CPB수술적45례CHD반중도PH환자진행회고분석,토론술후조기주요병발증화사망원인.결과 술후조기주요병발증유엄중저양혈증(13.33%)、결양발작(11.11%)、저심배(6.67%).주원사망솔6.67%,사망원인균위저심배,주요위우심실공능실대상.다인소분석현시,저온CPB(OR=0.56;95%CI 0.35-0.89)시엄중저양혈증적일개위험인소.결론 술후조기병발증주요유술후PH위기출적심폐공능불전소도치,대술후고위환자동태감측폐동맥압、우심공능화연장호흡궤지지,유조우방치병발증.
Objective A clinical analysis of early complications in patients with severe pulmonary hypertension(PH)undergoing congenital heart surgery with cardiopulmonary bypass(CPB)is reported.Methods A retrospective study of 45 patients with severe PH undergoing congenital heart surgery with CPB in our hospital from June 2003 to June 2009 was completed.The cause of death and the major complications in the early postoperative period were discussed.Results The major complications were severe hypoxemia,anoxic spell and low cardiac output.The mortality was 6.67%.The causes of death were all low cardiac output,which manifested decompensation of right ventricular function.By multivariate regression,Hypothermic CPB(OR=0.56;95%CI 0.35-0.89)was a risk factor for severe hypoxemia.Conclusion Early postoperative complications were mainly due to impaired function of heart and lungs,which based upon postoperative PH.Selective postoperative monitoring for pulmonary arterial pressure and right heart function,and prolonged mechanical ventilation for high risk patients may help to guide treatment and to prevent and cure early complications in these patients.