文档介绍：新生儿先天性心脏病手术的麻醉管理
作者:陈敏李杰张英民侯立朝熊利泽
【关键词】先天性心脏病
关键词: 新生儿;先天性心脏病;麻醉
摘要:目的探讨适合新生儿特点的先天性心脏病手术麻醉管理方法. 方法 10例先天性心脏病患儿年龄9~27(平均13)d,~()、心力衰竭和水、、机械通气;建立有创血液动力学监测;采用静吸复合维持麻醉;体外循环下进行心脏畸形矫治术;手术结束后在监护病房继续行机械通气,待患儿意识清醒、肌力和呼吸恢复正常后拔出气管内导管. 结果麻醉前有2例患儿在监护室即行气管内插管,1例术前静滴前列腺素E1(・kg-1 ・min-1 );全组均采用经鼻插入气管导管,采用CMV+;9例在心内手术完成后心脏均自动复跳并停用体外循环机,另1例患儿因左室发育差,未能停机;心脏自动复跳后常规用多巴胺2~8μg・kg-1 ・min-1 、~・kg-1 ・min-1 ;~・kg-1 ・min-1 ・kg-1 ・min-1 ,・kg-1 ・min-1 以维持循环稳定;术后1例死于未停机,另1例死于肺部并发症,其余8例均在术后4~6h时拔管,恢复顺利,术后10d出院. 结论术前对患儿病情的正确评估,选用正确的麻醉手术方法,术后加强监护是新生儿先天性心脏病手术成功的关键.
Keywords:infant,newborn;congenital heart disease;anes-thesia
Abstract:AIM To study anesthetic management for open-heart surgery on newborns with congenital heart Ten newborns,aged13(9~27)d with body (~)kg,scheduled for elective open-heart surgery,were included in this ,heart fail-ure and imbalance of fluid and electrolyte were treated before induction sequence was taken,followed by endotracheal intubation and mechanical then invasive hemodynamic monitoring was bined anes-thesia of intravenous and inhaled anesthesia were set to main-tain anesthesia for the w