DING Jin yang,MO Xu ming,GU Hai tao,et al. Delayed Sternal Closure following operations for complex and severe congenital heart disease in infant[J].Journal of Clinical Pediatric Surgery,2011,10(02):98-100.
延迟关胸技术在婴儿复杂危重先心病手术中的应用
- Title:
- Delayed Sternal Closure following operations for complex and severe congenital heart disease in infant
- Keywords:
- Cardiac Surgicalprocedures; Critical Illness; Heart Diseases/CN; Infant
- 文献标志码:
- A
- 摘要:
- 【摘要】目的探讨延迟关胸技术在婴儿复杂危重先天性心脏病(先心病)手术中的应用价值。方法2008年5月至2009年6月南京医科大学附属南京儿童医院共19例婴儿复杂危重先天性心脏病患儿接受术后延迟关胸治疗,患儿年龄2d至18个月,体重3~10kg,延迟关胸时间1~4d,平均(1.26±0.52)d。结果19例中,痊愈14例,死亡2例,2例放弃治疗,1例远期死亡。结论对于复杂危重先心病手术后出现低心排、血流动力学不稳定、出血、心律失常、心肌水肿等严重并发症的婴儿,延迟关胸是一种安全有效的解决方法。正确采取延迟关胸技术可以有效降低婴儿复杂危重先心病手术的死亡率。
- Abstract:
- 【Abstract】ObjectiveThe purpose of this study was to determine the effects of delayed sternal closure (DSC) in operations for complex and severe congenital heart disease in infants.MethodsBetween May 2008 and June 2009, 19 infant cases with complex and severe congenital heart disease underwent delayed sternal closure. The age ranged from 2 days to 18 months and the body weight ranged from 3 kg to10 kg. The traction was removed successfully in the ICU between 1 and 4 days (mean 1.26±0.52 days).ResultsIn 19cases, 14 were recovery, 2 deaths, 2 giving up treatment and 1 death a few months late. ConclusionThe technique of delayed sternal closure may help to overcome the problems such as low cardiac output syndrome, unstable hemodynamic conditions, hemorrhage, arhythmias, myocardium edema etc. DSC is a simple, safe and very useful technique for the complex cardiac diseases. DSC according to the indictors could decrease the mortality of the cardiac operations for the infant patients with complex and severe congenital heart disease effectively.
参考文献/References:
1丁文祥,苏肇伉.小儿心脏外科学\[J\].济南:山东科学技术出版社,2000,607—612.
2莫绪明.重视小婴儿复杂及重症先天性心脏病的早期外科治疗\[J\].临床小儿外科杂志.2009,8(1):4—7.
3Riahi M, Tomatis LA, Schlosser RJ. Cardiac compression due to closure of the median sternotomy in open-heart surgery\[J\].Chest,1975, 67:113—114.
4Joah NK, Tchervenkov CI, Anthony RC.et al. Delayed sternal closure:A lifesaving maneuver after early operation for complex congenital heart disease in the neonate\[J\].J Thorac Cardiovasc Surg,1989,98:413—416.
5Misava Y. What can be an indicator of delayed sternal closure after cardiac surgery?\[J\].Eur J Cardiothorac Surg,2002, 22(3): 493—494.
6Samir K,Riberi A,Ghez O,et al.Delayed sternal closure :a life-saving measure in neonatal open heart surgery; could it be predictable?\[J\].Eur J Cardiothorac Surg,2002,21(5):787—793.
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