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目的:探讨提高低体重婴幼儿心内直视手术临床疗效的方法。方法:对 2 8例 10 kg以下低体重先天性心脏病患儿采用体外循环心内直视手术 ,胶体预充为主 ,深低温、中低温以及浅低温不停跳下共完成室间隔缺损修补 2 1例 ,法鲁氏四联征根治 3例 ,室间隔缺损合并动脉导管未闭治疗 1例 ,房间隔缺损合并肺静脉异位引流矫正术 3例。转机流量 85～ 170 ml/ kg· min。术后常规使用多巴胺、多巴酚丁胺、硝普钠 ,加强术前术后呼吸道管理。结果 :术后无死亡病例 ,均痊愈出院。随访 3个月 ,手术效果良好 ,随访率 10 0 %。结论 :采用胶体为主的预充 ,使用膜式氧合器 ,良好的心肌保护 ,满意的畸形矫正 ,加强术前术后的呼吸道管理 ,能有效降低术后并发症和死亡率。
Objective: To explore ways to improve the clinical efficacy of open heart surgery in infants with low birth weight. Methods: 28 cases of congenital heart disease under 10 kg weight were treated with open heart surgery under cardiopulmonary bypass, colloidal preconditioning, deep hypothermia, hypothermia, and hypothermia to complete a total of ventricular septal defect repair 21 cases, Faruq quadruple sign radical cure in 3 cases, ventricular septal defect with patent ductus arteriosus treatment in 1 case, atrial septal defect with pulmonary vein heterotopic drainage correction in 3 cases. Turnover traffic 85 ~ 170 ml / kg · min. Postoperative routine use of dopamine, dobutamine, sodium nitroprusside, to strengthen preoperative and postoperative respiratory tract management. Results: No postoperative deaths were cured. Follow-up 3 months, the operation effect is good, the follow-up rate was 100%. Conclusion: Preconditioning with colloid, using membrane oxygenator, good myocardial protection, satisfactory deformity correction and strengthening of respiratory tract management before and after operation can effectively reduce postoperative complications and mortality.