CAJ | 학술논문

目的总结大动脉调转手术(ASO)围手术期处理方法,提高患儿的手术存活率.方法 2007年1月至2008年3月我科实施ASO术20例.男17例,女3例,年龄14 d～4岁,平均(4.7±3.6)个月.体重3.0～17.0 kg,平均(5.0±3.3)kg.术前诊断包括完全性大动脉转位室间隔完整型(TGA/IVS)14例,完全性大动脉转位合并室间隔缺损(TGA/VSD)5例,右室双出口伴肺动脉瓣下室间隔缺损(Taussig-Bing综合征)1例.结果住院死亡2例,术后并发症包括低氧血症10例,肺部感染4例,呼吸衰竭二次插管2例,左肺不张1例,房性心律失常1例,室性心律失常1例,伤口愈合不良2例.结论大动脉调转手术术前应该积极改善患儿缺氧情况,纠正酸中毒,严重缺氧呼吸衰竭者要急诊手术,术后加强左心功能维护,降低肺动脉压力,同时加强呼吸道管理.
목적 총결대동맥조전수술(ASO)위수술기처리방법,제고환인적수술존활솔.방법 2007년1월지2008년3월아과실시ASO술20례.남17례,녀3례,년령14 d～4세,평균(4.7±3.6)개월.체중3.0～17.0 kg,평균(5.0±3.3)kg.술전진단포괄완전성대동맥전위실간격완정형(TGA/IVS)14례,완전성대동맥전위합병실간격결손(TGA/VSD)5례,우실쌍출구반폐동맥판하실간격결손(Taussig-Bing종합정)1례.결과 주원사망2례,술후병발증포괄저양혈증10례,폐부감염4례,호흡쇠갈이차삽관2례,좌폐불장1례,방성심률실상1례,실성심률실상1례,상구유합불량2례.결론 대동맥조전수술술전응해적겁개선환인결양정황,규정산중독,엄중결양호흡쇠갈자요급진수술,술후가강좌심공능유호,강저폐동맥압력,동시가강호흡도관리.
Objective To summarize the experience of perioperative management for arterial switch operations (ASO).Methods From Feb 2007 to Mar 2008,20 infants (17 males and 3 females) with complex congenital heart diseases underwent switch procedures.The mean age of patients was (4.7±3.6) months,ranging from 14 days to 4 years.The mean body weight was (5.0±3.3) kg,ranging from 3.0 to 17.0 kg.The pre-operative diagnosis for all the patients included transposition of great arteries (TGA) with intact ventricular septum (TGA/IVS) in 14 cases,TGA with ventricular septal defect (TGA/VSD) in 5,and Taussig-Bing anomaly in 1.Results Two patients died during hospitalization,with the mortality rate at 10%.Postoperative complications included hypoxemia in 10 Cases,lung infection in 4,reintubation in 2,sinister atelectasis in 1,atrial tachyeardia in 1,ventricular tachycardia in 1,and bad wound healing in 2.Condmions Before ASO,anoxemia and metabolic acidosis should be treated.Urgent operation was needed when severe hypoxemia and respiratory failure occurred.During postoperative management,maintenance of left ventricular function,decreasing pulmonary resistance and intensifying respiratory management is necessary.