Liu Yuhang,Wen Ping,Liu Qilong,et al.Emergency and sub-emergency operations for congenital heart disease in 75 infants with a low age and a low body weight[J].Journal of Clinical Pediatric Surgery,,18():779-783.[doi:10.3969/j.issn.1671-6353.2019.09.015]
Emergency and sub-emergency operations for congenital heart disease in 75 infants with a low age and a low body weight
- Keywords:
- Heart Diseases/CN; Low Body Weight; Infant; Treatment Outcome
- CLC:
- R726;R654.2
- Abstract:
- Objective To explore the perioperative management of emergency and sub-emergency open heart operations for congenital heart disease (CHD) in infants aged under 6 months with a low body weight of 5 kg or less.Methods From January 2014 to April 2017,emergency and sub-emergency open heart operations were performed for 75 CHD infants aged under 6 months of age with a body weight of (4.2±0.8) kg.Radical (n=69) and palliative (n=6) operations were performed.Results Among them,5 (6.67%) died in hospital due to low cardiac syndrome (n=3),severe infection (n=1) and acute pericardial tamponade (n=1).The remainders survived and were followed up for 1 to 40 months.Among 64 survivors of radical procedures,there were a small residual ventricular septal defect (n=2),aortic arch flow velocity (n=2) and accelerated blood flow velocity in pulmonary vein anastomosis (n=1).Cardiac silhouette narrowed and pulmonary artery pressure was normal.Six cases of palliative surgery were significantly relieved and 2 cases completed the second stage of surgery.Conclusion With the improvements of perioperative management,anesthesia,cardiopulmonary bypass and surgical techniques,emergency and sub-emergency open heart operations are both safe and efficacious for CHD infants aged under 6 months with a low birth weight of 5 kg.
References:
1 莫绪明.我国小儿先心病外科面临的挑战与思考[J].临床小儿外科杂志,2016,15(3):209-211.DOI:10.3969/j.issn.1671-6353.2016.03.001. Mo XM.Challenges and considerations of operations for Chinese children with congenital heart disease[J].Clin Ped Sur,2016,15(3):209-211.DOI:10.3969/j.issn.1671-6353.2016.03.001.
2 Lacroix J,Tucci M.Clinical impact of length of storage before red blood cell transfusion[J].Transfus Clin Biol,201l,18(2):97-105.DOI:10.1016/j.tracli.2011.02.020.
3 Mahle WT,Matthews E,Kanter KR,et al.Inflammatory response after neonatal cardiac surgery and its relationship to clinical outcomes[J].Ann Thorac Surg,2014,97(3):950-956.DOI:10.1016/j.athoracsur.2013.10.069.
4 缪娜,杨璟,杜中涛,等.血液回收技术对婴幼儿心脏外科术后临床结果的影响[J].中国体外循环杂志,2015,13(1):11-14.DOI:10.13498/j.cnki.chin.j.ecc.2015.01.03. Miao N,Yang J,Du ZT,et al.Effects of cell saver on blood transition and postoperative clinical outcomes for pediatric patients undergoing cardiac surgery[J].Chinese Journal of Extracorporeal Circulation,2015,13(1):11-14.DOI:10.13498/j.cnki.chin.j.ecc.2015.01.03.
5 李晓峰,罗丹东,朱卫中,等.延迟关胸在新生儿先天性心脏病术后的应用[J].中华胸心血管外科杂志,2016,32(5):257-260.DOI:10.3760/cma.j.issn.1001-4497.2016.05.001. Li XF,Luo DD,Zhu WZ,et al.Application of delayed sternal closure after neonatal surgery for congenital heart disease[J].Chin J Thorac Cardiovasc Surg,2016,32(5):257-260.DOI:10.3760/cma.j.issn.1001-4497.2016.05.001.
6 Antonucci E,Lippi G,Ticinesi A,et al.Neutrophil gelatinase associated lipocalin (NGAL):a promising biomarker for the early diagnosis of acute kidney injury (AKI)[J].Acta Biomed,2014,85(3):289-294.
7 闫芳,刘艳兵,邢蓓蓓,等.KIM1及NGAL在婴幼儿复杂先心病术后早期肾功能损伤中的预测作用[J].临床小儿外科杂志,2016,15(3):231-234.DOI:10.3969/j.issn.1671-6353.2016.03.008. Yan F,Liu YB,Xing BB,et al.Early prediction values of detecting KIM-1 and NGAL in acute kidney injury after complex surgery for congenital heart disease[J].Clin Ped Sur,2016,15(3):231-234.DOI:10.3969/j.issn.1671-6353.2016.03.008.
8 袁源,鲍春荣,丁芳宝,等.完全性肺静脉异位引流合并左心室发育不全矫治手术中房间隔留窗的应用[J].中华胸心血管外科杂志,2015,31(3):134-137.DOI:10.3760/cma.j.issn.1001-4497.2015.03.002. Yuan Y,Bao CR,Ding FB,et al.Application of atrial septal fenestrating in correcting total anomalous pulmonary venous connection with left ventricular hypoplasia[J].Chin J Thorac Cardiovasc Surg,2015,31(3):134-137.DOI:10.3760/cma.j.issn.1001-4497.2015.03.002.
9 Chan KL,Ip P,Chiu CS,et al.Peritoneal dialysis after surgery for congenital heart disease in infants and young children[J].Annals of Thoracic Surgery,2003,76(5):1443-1449.DOI:10.1016/S0003-4975(03)01026-9.
10 Sorof JM,Stromberg D,Brewer ED,et al.Early initiation of peritoneal dialysis after surgical repair of congenital heart disease[J].Pediatric Nephrology,1999,13(8):641-645.DOI:10.1007/s004670050672.
11 Pedersen KR,Hjortdal VE,Christensen S,et al.Clinical outcome in children with acute renal failure treated with peritoneal dialysis after surgery for congenital heart disease[J].Kidney Int Suppl,2008,73(108):S81-S86.DOI:10.1038/sj.ki.5002607.
12 Santos CR,Branco PQ,Gaspar A,et al.Use of Peritoneal Dialysis After Surgery for Congenital Heart Disease in Children[J].Peritoneal Dialysis International Journal of the International Society for Peritoneal Dialysis,2012,32(3):273-279.DOI:10.3747/pdi.2009.00239.
13 张振龙,陈良万,黄雪珊,等.完全性肺静脉异位引流外科治疗61例临床分析[J].福建医科大学学报,2011,45(6):458-459,463.DOI:10.3969/j.issn.1672-4194.2011.06.017. Zhang ZL,Chen LW,Huang XS,et al.Clinical analysis of 61 cases of complete anomalous pulmonary venous drainage[J].Journal of Fujian Medical University,2011,45(6):458-459,463.DOI:10.3969/j.issn.1672-4194.2011.06.017.
Memo
收稿日期:2018-08-08。
通讯作者:文平,Email:13504115999@163.com