中国医药
中國醫藥
중국의약
CHINA MEDICINE
2014年
3期
388-392
,共5页
李刚%苏俊武%范祥明%李志强%张晶%许耀强%刘承虎%杨学勇%张辉%刘迎龙
李剛%囌俊武%範祥明%李誌彊%張晶%許耀彊%劉承虎%楊學勇%張輝%劉迎龍
리강%소준무%범상명%리지강%장정%허요강%류승호%양학용%장휘%류영룡
先天性心脏病%婴儿%心脏手术%呼吸功能障碍
先天性心髒病%嬰兒%心髒手術%呼吸功能障礙
선천성심장병%영인%심장수술%호흡공능장애
Congenital hear disease%Infant%Cardiac surgery%Respiratory insufficiency
目的 研究右腋下小切口剖胸心内直视手术对婴儿室间隔缺损围术期呼吸功能的影响.方法 回顾性分析2010年3月至2013年9月在北京安贞医院行手术矫治的5 kg以下婴儿室间隔缺损病例198例,手术入路包括右腋下小切口剖胸85例(右侧组)和正中切口开胸113例(正中组).比较围术期资料和呼吸参数(气道峰压、氧分压、二氧化碳分压、氧合指数、肺泡-动脉氧分压差)的差异.结果 右侧组手术时间、术后住院时间较正中组短[(144±22)min比(152±23) min,(7.1±2.6) d 比(8.9±3.7)d,均P<0.05],其他围术期指标差异无统计学意义(P＞0.05).2组病死率均为0,并发症的发生率差异无统计学意义[右侧组3.5%(3/85),正中组5.3%(6/113)](P＞0.05).2组病例麻醉后、手术后、入重症监护病房时、拔管前4个时间点的气道峰压、氧分压、二氧化碳分压、氧合指数、肺泡-动脉氧分压差差异无统计学意义(P＞0.05).结论 右腋下小切口剖胸心内直视手术不加重婴儿简单先天性心脏病术后呼吸功能不全.
目的 研究右腋下小切口剖胸心內直視手術對嬰兒室間隔缺損圍術期呼吸功能的影響.方法 迴顧性分析2010年3月至2013年9月在北京安貞醫院行手術矯治的5 kg以下嬰兒室間隔缺損病例198例,手術入路包括右腋下小切口剖胸85例(右側組)和正中切口開胸113例(正中組).比較圍術期資料和呼吸參數(氣道峰壓、氧分壓、二氧化碳分壓、氧閤指數、肺泡-動脈氧分壓差)的差異.結果 右側組手術時間、術後住院時間較正中組短[(144±22)min比(152±23) min,(7.1±2.6) d 比(8.9±3.7)d,均P<0.05],其他圍術期指標差異無統計學意義(P＞0.05).2組病死率均為0,併髮癥的髮生率差異無統計學意義[右側組3.5%(3/85),正中組5.3%(6/113)](P＞0.05).2組病例痳醉後、手術後、入重癥鑑護病房時、拔管前4箇時間點的氣道峰壓、氧分壓、二氧化碳分壓、氧閤指數、肺泡-動脈氧分壓差差異無統計學意義(P＞0.05).結論 右腋下小切口剖胸心內直視手術不加重嬰兒簡單先天性心髒病術後呼吸功能不全.
목적 연구우액하소절구부흉심내직시수술대영인실간격결손위술기호흡공능적영향.방법 회고성분석2010년3월지2013년9월재북경안정의원행수술교치적5 kg이하영인실간격결손병례198례,수술입로포괄우액하소절구부흉85례(우측조)화정중절구개흉113례(정중조).비교위술기자료화호흡삼수(기도봉압、양분압、이양화탄분압、양합지수、폐포-동맥양분압차)적차이.결과 우측조수술시간、술후주원시간교정중조단[(144±22)min비(152±23) min,(7.1±2.6) d 비(8.9±3.7)d,균P<0.05],기타위술기지표차이무통계학의의(P＞0.05).2조병사솔균위0,병발증적발생솔차이무통계학의의[우측조3.5%(3/85),정중조5.3%(6/113)](P＞0.05).2조병례마취후、수술후、입중증감호병방시、발관전4개시간점적기도봉압、양분압、이양화탄분압、양합지수、폐포-동맥양분압차차이무통계학의의(P＞0.05).결론 우액하소절구부흉심내직시수술불가중영인간단선천성심장병술후호흡공능불전.
Objective To explore the influence of minimally invasive open heart surgery for low birth weight infants through the right sub-axillary short incision on perioperative respiratory function. Methods Between March 2010 and September 2013, 198 infants below 5 kg underwent one stage repair with ventricular septal defects. All patients were divided into right group (85 cases via right subaxillary short incision) and median group (113 cases via median sternotomy). Perioperative general data, including preoperative, intraoperative and postoperative parameters were recorded; respiratory parameters including peak airway pressure, partial pressure of oxygen, partial pressure of carbon dioxide, oxygenation index and alveolar-arterial oxygen gradient were measured after anesthesia. Results The differences of preoperative data between right group and median group were insignificant. The length of operation [(144±22)min vs (152±23)min] and postoperative stay [(7.1±2.6)d vs (8.9±3.7)d] was shorter in the right group, compared to the median group (P<0.05). No deaths occurred and there was a low incidence of complications in both groups (P>0.05). In addition, the differences of peak airway pressure, partial pressure of oxygen, partial pressure of carbon dioxide, oxygenation index and alveolar-arterial oxygen gradient between the two groups were all not significant (P>0.05). Conclusion The minimally invasive approach through right sub-axillary short incision for uncomplicated congenital heart disease in infants with low body weight do not aggravate postoperative respiratory insufficiency.
