目的:冠状动脉起源于肺动脉(ALCAPA)是一种少见但危及生命的先天性心脏畸形,部分患儿伴发严重的心脏扩大,心肌功能受损,冠脉移植术后转归存在个体差异.本文分析此类患儿术后早期心脏功能恢复特点,并探讨影响术后早期恢复的相关影响因素.
目的:合并内脏异位的先心病患者具有较高的术后死亡率和呼吸道并发症。鉴于气道黏液清除机制和左右体轴发育模式都需要动力纤毛的功能,因此,我们想通过这项前瞻性研究来探索合并内脏异位的先心病患者是否存在纤毛功能障碍及其对呼吸道并发症的影响。<br> 目的:冠状动脉起源于肺动脉(ALCAPA)是一种少见但危及生命的先天性心脏畸形,由于术前常常伴发严重的心肌功能受损,术后早期恢复存在特殊性。本文分析此类患儿术后早期心脏功能恢复特点,并探讨影响术后早期恢复的相关影响因素。
Objective: To explore the relationship between thyroid hormone levels and prolonged recovery after cardiac surgery with cardiopulmonary bypass (CPB) in congenital heart disease (CHD) children younger than 1 year of age. Methods: A total of 186 CHD children younger than 1 year treated in our hospital from 2014-01 to 2015-01 were retrospectively summarized. According to the pediatric intensive care unit (PICU) stay time, the patients were divided into 2 groups: Prolonged recovery group, the patients stated in PICU≥5 days,n=39 and Non-prolonged recovery group, the patients stayed in PICU<5 days,n=147. Thyroid hormone levels within 24 hours of operation with prolonged recovery conditions were studied. Results: Compared with Non-prolonged recovery group, the patients in Prolonged recovery group showed decreased levels of FT3 (2.02 ± 0.48) pg/ml vs (2.27 ± 0.46) pg/ml, TT3 (0.59 ± 0.30) ng/dl vs (0.71 ± 0.24) ng/dl and TT4 (5.39 ± 2.58)μg/ml vs (6.49 ± 2.20) μg/ml, allP<0.05; while the levels of free thyroid hormone and thyrotropin were similar between 2 groups,P>0.05. Multivariable logistical regression analysis presented that low level of FT3 within 24 hours of operation was the independent risk factor for prolonged recovery (OR= 0.32, 95% CI 0.12-0.84,P=0.02); linear regression analysis indicated that post-operative reduction of thyroid hormone was related to low body weight of the patients (r=0.11,P<0.001). Conclusion: Lower body weight was usually having lower level of FT3 within 24 hours of operation, which was the independent predictor for prolonged recovery in CHD children younger than 1 year after cardiac surgery.
目的:先天性心脏病术后并发急性肾功能损伤患儿死亡率高达30%~79%,腹膜透析(PD)临床最常用的治疗手段,但目前对于PD的最佳治疗时机还存在争论。本文目的旨在探讨先天性心脏病术后早期PD对患儿早期预后的影响。
目的:通过对先心病外科快速康复技术下患儿围手术期临床资料的分析,探讨积极早拔管策略在低龄复杂先心病术后实施的可行性。并分析可能影响早期拔管(呼吸机辅助时间≤24 h)的相关风险因素。
目的:心脏手术后快速康复是一项多学科协作的综合性技术。是在保证医疗质量的前提下,缩短呼吸机辅助及ICU 滞留时间,降低医疗费用,加快床位周转,从而减轻社会及家庭的负担。其中,早期拔管(early extubation,EE)是快速康复技术中最为重要的步骤。目前简单先心病及部分复杂先心病(如完全性房室通道、右心旁路手术)术后的快速康复已在临床工作中得到常规应用。但鉴于复杂先心病整体心脏畸形与手术方式的复杂性,复杂先心病术后早期拔管仍然需要进行深入研究。本文探讨小儿完全性大动脉转位行大动脉调转术后早期拔管的可行性及相关风险因素。
目的:分析先天性心脏病术后急性心肺复苏的原因。<br> 方法:2011年1月至2012年12月共31例患儿术后出现心跳骤停,主要疾病包括:大动脉转位、单心室、法乐氏四联症、右室双出口、室间隔缺损合等。年龄2个月~7岁;体重5.2~21 kg。7例患儿为手术后24 h内出现心血管事件,其中2例为switch手术,2例为全腔手术,1例为体肺分流手术,1例为室缺修补手术,1例为室缺封堵手术。4例为术后24 h以后出现,1例为体肺分流手术,1例为TOF根治手术,2例为DORV矫治手术。20例患儿出现呼吸窘迫,8例患儿行气管插管,呼吸机支持,12例患儿需经鼻气管内吸痰或CPAP辅助。