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目的分析主动脉缩窄(coarctation of aorta,COA)合并心内畸形伴重症肺炎手术治疗的效果。方法回顾性分析2014年1月至2015年8月我院26例COA合并心内畸形伴重症肺炎患儿的临床资料,其中男18例、女8例,年龄6 d至26个月,中位年龄5.5个月,经内科治疗肺炎不能缓解,其中7例(26.9%)带气管插管行急症手术治疗。双切口5例,单切口21例。远期随访资料通过门诊获得。结果院内死亡2例,平均住院时间(18.5±4.5)d,体外循环时间(93.5±36.4)min,术后呼吸机辅助时间(89.5±41.3)min。术后并发症主要为肺部炎症感染。门诊随访6个月,患儿肺炎发病率降低,生长发育状况明显改善。结论 COA合并心内畸形并发肺炎在感染不能控制的情况下,仍可进行手术矫治,并能取得很好的疗效。
Objective To analyze the effect of surgical treatment of coarctation of aorta (COA) with intracardiac deformity and severe pneumonia. Methods The clinical data of 26 children with COA complicated with severe pneumonia admitted to our hospital from January 2014 to August 2015 were retrospectively analyzed. Among them, 18 were males and 8 were females, ranging in age from 6 days to 26 months Age 5.5 months, medical treatment of pneumonia can not be alleviated, of which 7 cases (26.9%) with tracheal intubation emergency surgery. Double incision in 5 cases, single incision in 21 cases. Long-term follow-up data obtained through the clinic. Results The hospital died in 2 cases, the average length of hospital stay was (18.5 ± 4.5) days, the time of cardiopulmonary bypass (93.5 ± 36.4) min and the time of ventilator assisted after operation (89.5 ± 41.3) min. Postoperative complications mainly include lung inflammation. Outpatient follow-up of 6 months, the incidence of pneumonia in children reduced, growth and development significantly improved. Conclusion COA combined with intra-cardiac deformity complicated by pneumonia can not be controlled in the case of infection, surgical correction can be performed, and can achieve good results.