【摘要】：研究目的:回顧分析心腦聯(lián)合灌注和單純區(qū)域性腦灌注兩種體外循環(huán)灌注策略在復(fù)雜主動脈畸形患兒手術(shù)中的應(yīng)用效果,并比較兩者對患兒早期預(yù)后的影響。研究方法:收集本中心2011年1月至2014年8月141例患有主動脈縮窄或主動脈弓中斷合并心內(nèi)畸形的小兒術(shù)前、術(shù)中及術(shù)后相關(guān)臨床資料,年齡為1個月至94個月,根據(jù)患兒術(shù)中體外循環(huán)灌注方式將其分為心腦聯(lián)合灌注組(n=56)和單純區(qū)域性腦灌注組(n=85)。回顧性觀察并分析兩組患兒術(shù)中各項相關(guān)參數(shù)、術(shù)后生化指標、恢復(fù)情況及不良事件發(fā)生率等,用統(tǒng)計學(xué)的方法比較兩組患兒術(shù)后的早期預(yù)后是否存在差異。研究結(jié)果:心腦聯(lián)合灌注組的術(shù)中參數(shù)如體外循環(huán)時間、停循環(huán)時間、心臟停跳時間、手術(shù)時間、復(fù)溫時間等均較單純區(qū)域性腦灌注組明顯縮短(P0.001),并且心腦聯(lián)合灌注組患兒術(shù)后的天門冬氨酸轉(zhuǎn)氨酶、直接膽紅素、總膽紅素和血尿素氮、肌酐等肝腎功能指標也較明顯降低(P0.001)。除此之外,心腦聯(lián)合灌注組的術(shù)后恢復(fù)參數(shù)如呼吸機時間和住院時間也較單純區(qū)域性腦灌注組有所縮短,P值分別是 0.015 和 0.007。研究結(jié)論:在小兒主動脈弓體外循環(huán)手術(shù)中,選用心腦聯(lián)合灌注的改良灌注策略較單純區(qū)域性腦灌注可使患兒獲得更好的預(yù)后,使患兒的住院時間和呼吸機支持時間縮短。
[Abstract]:Objective: to retrospectively analyze the effects of cardiopulmonary bypass (CPB) perfusion strategies of combined cardio-cerebral perfusion and regional cerebral perfusion in children with complex aortic malformation and compare their effects on the early prognosis of children with complex aortic malformation. Methods: from January 2011 to August 2014, 141 children with coarctation of aorta or interruption of aortic arch with intracardiac malformation were collected. According to the cardiopulmonary bypass (CPB) during the operation, the children were divided into two groups: the combined cardio-cerebral perfusion group (NN56) and the regional cerebral perfusion group (nong85). The related parameters, biochemical indexes, recovery and incidence of adverse events in the two groups were retrospectively observed and analyzed. The early prognosis of the two groups was compared by statistical method. Results: intraoperative parameters such as cardiopulmonary bypass time, cardiac arrest time, operation time, The rewarming time was significantly shorter than that in the regional cerebral perfusion group (P0.001), and the indexes of aspartate aminotransferase, direct bilirubin, total bilirubin, blood urea nitrogen and creatinine were also significantly decreased in the combined cardio-cerebral perfusion group (P0.001). In addition, the postoperative recovery parameters such as ventilator time and hospital stay in the combined cardio-cerebral perfusion group were significantly shorter than those in the regional perfusion group (P = 0.015 and 0.007, respectively). Conclusion: in pediatric aortic arch cardiopulmonary bypass, the improved perfusion strategy of combined cardio-cerebral perfusion is better than that of regional cerebral perfusion alone, and the hospitalization time and ventilator support time can be shortened.
【學(xué)位授予單位】：北京協(xié)和醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R726.1

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相關(guān)期刊論文 前2條

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