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目的 评价体外循环下不阻断升主动脉行心内直视术对小儿心肌的保护作用。方法 回顾性分析 1995年 9月至 2 0 0 1年 6月 ,312例应用此法手术的小儿先天性心脏病病例。全组男 16 0例 ,女15 2例。平均年龄 (3 2 5± 1 34)岁。平均体重 (14 6 1± 3 72 )kg。病种包括室间隔缺损、房间隔缺损、法洛四联症、法洛三联症、房室通道、部分性肺静脉畸形引流、肺动脉瓣狭窄、三房心和三尖瓣下移。在浅低温心脏跳动下手术 2 13例 ,中低温停跳下手术 99例。结果 全组无脑气栓发生。随访 2～ 36个月。术后出现低心输出量综合征 6例、支气管痉挛 3例、肾功能衰竭 2例、血红蛋白尿 32例。全组死亡 7例(2 2 4 % )。结论 不阻断升主动脉 ,浅、中低温体外循环心脏停跳或不停跳下心内直视术 ,用于小儿先天性心脏病矫治 ,心肌保护安全有效 ,临床效果满意
Objective To evaluate the protective effects of cardiopulmonary bypass without ascending aorta under cardiopulmonary bypass. Methods From September 1995 to June 2001, 312 cases of pediatric congenital heart disease undergoing this procedure were retrospectively analyzed. The whole group of male 160 cases, female 15 2 cases. The average age (3 2 5 ± 1 34) years old. Average body weight (14 6 1 ± 3 72) kg. Diseases include ventricular septal defect, atrial septal defect, tetralogy of Fallot, tetralogy of Fallot, atrioventricular access, partial pulmonary venous anomalies drainage, pulmonary valve stenosis, three heart and tricuspid regurgitation. In mild hypothermic heart beats under the operation of 2 13 cases, 99 cases of hypothermia surgery. Results No anemia in the whole group occurred. Followed up for 2 to 36 months. Postoperative low cardiac output syndrome in 6 cases, bronchospasm in 3 cases, 2 cases of renal failure, hemoglobinuria in 32 cases. The whole group died in 7 cases (22.4%). Conclusion It is safe and effective in preventing and treating cardiac congenital heart disease without blocking the ascending aorta, cardiopulmonary bypass or beating heart under light and medium temperature.