中华实用儿科临床杂志
中華實用兒科臨床雜誌
중화실용인과림상잡지
Journal of Applied Clinical Pediatrics
2014年
23期
1785-1787
,共3页
先天性心脏病%简易腹膜透析%低心排综合征%儿童
先天性心髒病%簡易腹膜透析%低心排綜閤徵%兒童
선천성심장병%간역복막투석%저심배종합정%인동
Congenital heart disease%Simple peritoneal dialysis%Low cardiac output syndrome%Child
目的 探讨儿童重症先天性心脏病术后合并低心排综合征(LCOS)早期应用简易腹膜透析对围术期治疗的影响.方法 选择2013年1月至6月北京军区总医院附属八一儿童医院儿童外科重症监护专科(ICU)收治的53例合并LCOS的重症先天性心脏病术后应用简易腹膜透析患儿,对患儿的心、肺、肾等重要脏器功能指标进行研究.年龄2d～2岁,体质量2～8 kg.其中室间隔完整完全性大动脉转位(TGA/IVS)8例,法洛四联症(TOF) 10例,肺动脉闭锁(PA) 10例,主动脉弓离断(IAA)6例,完全肺静脉异位引流(TAPVC)6例,主动脉缩窄(COA)5例,右心室双出口(DORV)4例,完全心内膜垫缺损(CAVC)3例,室间隔缺损(VSD)1例.结果 治愈50例,术后简易腹膜透析治疗2～10d,住监护室治疗时间2～15 d,尿量恢复正常1～3d,血清肌酐、尿素氮恢复时间为术后3～10 d,乳酸降至正常时间1～3d,其中3例因严重LCOS,复苏困难予体外膜肺氧合(ECMO)治疗,术后恢复良好;3例死亡.结论 简易腹膜透析方便、安全、创伤小、廉价、效果好,可提高患儿生存率,减少并发症,缩短呼吸机辅助呼吸时间及ICU滞留时间,节省住院时间及费用.
目的 探討兒童重癥先天性心髒病術後閤併低心排綜閤徵(LCOS)早期應用簡易腹膜透析對圍術期治療的影響.方法 選擇2013年1月至6月北京軍區總醫院附屬八一兒童醫院兒童外科重癥鑑護專科(ICU)收治的53例閤併LCOS的重癥先天性心髒病術後應用簡易腹膜透析患兒,對患兒的心、肺、腎等重要髒器功能指標進行研究.年齡2d～2歲,體質量2～8 kg.其中室間隔完整完全性大動脈轉位(TGA/IVS)8例,法洛四聯癥(TOF) 10例,肺動脈閉鎖(PA) 10例,主動脈弓離斷(IAA)6例,完全肺靜脈異位引流(TAPVC)6例,主動脈縮窄(COA)5例,右心室雙齣口(DORV)4例,完全心內膜墊缺損(CAVC)3例,室間隔缺損(VSD)1例.結果 治愈50例,術後簡易腹膜透析治療2～10d,住鑑護室治療時間2～15 d,尿量恢複正常1～3d,血清肌酐、尿素氮恢複時間為術後3～10 d,乳痠降至正常時間1～3d,其中3例因嚴重LCOS,複囌睏難予體外膜肺氧閤(ECMO)治療,術後恢複良好;3例死亡.結論 簡易腹膜透析方便、安全、創傷小、廉價、效果好,可提高患兒生存率,減少併髮癥,縮短呼吸機輔助呼吸時間及ICU滯留時間,節省住院時間及費用.
목적 탐토인동중증선천성심장병술후합병저심배종합정(LCOS)조기응용간역복막투석대위술기치료적영향.방법 선택2013년1월지6월북경군구총의원부속팔일인동의원인동외과중증감호전과(ICU)수치적53례합병LCOS적중증선천성심장병술후응용간역복막투석환인,대환인적심、폐、신등중요장기공능지표진행연구.년령2d～2세,체질량2～8 kg.기중실간격완정완전성대동맥전위(TGA/IVS)8례,법락사련증(TOF) 10례,폐동맥폐쇄(PA) 10례,주동맥궁리단(IAA)6례,완전폐정맥이위인류(TAPVC)6례,주동맥축착(COA)5례,우심실쌍출구(DORV)4례,완전심내막점결손(CAVC)3례,실간격결손(VSD)1례.결과 치유50례,술후간역복막투석치료2～10d,주감호실치료시간2～15 d,뇨량회복정상1～3d,혈청기항、뇨소담회복시간위술후3～10 d,유산강지정상시간1～3d,기중3례인엄중LCOS,복소곤난여체외막폐양합(ECMO)치료,술후회복량호;3례사망.결론 간역복막투석방편、안전、창상소、렴개、효과호,가제고환인생존솔,감소병발증,축단호흡궤보조호흡시간급ICU체류시간,절성주원시간급비용.
Objective To study the effect of simple peritoneal dialysis on the treatment of severe congenital heart disease(CHD) after operation complicated with low cardiac output syndrome(LCOS) in children with perioperative therapy.Methods After operation,fifty-three cases of severe CHD complicated with LCOS and the application of easy peritoneal dialysis were collected from Jan.to Jun.2013 in Department of Children's Surgical Intensive Care Specialist,Bayi Children's Hospital were collected.Functional parameters of vital organs,e.g.lung,kidney and heart were observed.Ages varied from 2 days to 2 years old,body weight from 2 to 8 kg.It contained 8 cases of complete transposition of great arteries with intact ventricular septum(TGA/IVS),10 cases of Tetralogy of Fallot(TOF),10 cases of pulmonary atresia (PA),6 cases of interruption of aortic arch (IAA),totally anomalous pulmonary venous drainage (TAPVC) in 6 cases,5 cases of coarctation of the aorta (COA),4 cases with right ventricular double outlet (DORV),3 cases with endocardial cushion defect(CAVC),1 case with ventricular septal defect(VSD).Results Fifty cases were completely cured,postoperative simple peritoneal dialysis treatment for 2 to 10 days,living ICU treatment time 2-15 days,urine output returns to normal 1-3 days,serum creatinine,blood urea nitrogen recovery time after 3-10.days,lactic acid to normal time 1-3 days,and 3 cases complicated with severe LCOS received extracorporeal membrane oxygenation therapy for difficult recovery,and postoperative recovery was good.Three cases died.Conclusions Easy peritoneal dialysis is convenient,safe,minimally invasive,inexpensive and effective.It can improve survival rate and reduce complications,shorten the time of mechanical ventilation and ICU residence time,hospitalization time and cost savings.
