西藏先天性心脏病患儿在低海拔地区行手术麻醉的围手术期安全性

发布时间：2018-09-12 13:35

【摘要】：目的:观察高海拔地区先天性心脏病患儿到低海拔地区行先天性心脏病矫治手术的临床指标和短期预后,以探讨其围手术期的安全性。方法:回顾性分析2016年1至12月在中南大学湘雅医院择期行先天性心脏病矫治手术的来自西藏自治区(X组)和湖南省(H组)的患儿各7例。比较两组患儿心脏超声心动图检查指标、围手术期血流动力学、术后恢复与并发症和围手术期氨基末端脑钠肽前体(N terminal pro B type natriuretic peptide,NT-proBNP)水平。结果:心脏超声心动图显示两组患儿心脏结构和心功能无明显差异,X组患儿肺高压的发生率明显高于H组(P0.05)。围手术期血流动力学比较两组之间差异无统计学意义(P0.05),术后ICU停留时间X组患儿更长(P0.05)。血清NT-proBNP水平X组患儿明显高于H组(P0.05)。结论:高海拔地区的先天性心脏病患儿到低海拔地区行先天性心脏病矫治手术有助于提高围手术期安全性,麻醉手术中血流动力学平稳,但术后心功能不全风险仍高于低海拔地区患儿,术后恢复时间延长。
[Abstract]:Objective: to observe the clinical indexes and short-term prognosis of children with congenital heart disease (CHD) from high altitude to low altitude, and to explore the safety of the perioperative period. Methods: from January to December 2016, 7 children from Tibet Autonomous region (group X) and 7 children from Hunan province (group H) who underwent elective correction of congenital heart disease in Xiangya Hospital of Central South University were analyzed retrospectively. The indexes of echocardiography, hemodynamics, postoperative recovery and complications, and the level of amino-terminal brain natriuretic peptide precursor (N terminal pro B type natriuretic peptide,NT-proBNP) were compared between the two groups. Results: the incidence of pulmonary hypertension in group X was significantly higher than that in group H (P0.05). There was no significant difference in hemodynamics between the two groups in perioperative period (P0.05). Postoperative ICU stay time in group X was longer than that in control group (P0.05). Serum NT-proBNP level in group X was significantly higher than that in group H (P0.05). Conclusion: it is helpful to improve the perioperative safety of congenital heart disease in children with congenital heart disease at high altitude and to treat congenital heart disease at low altitude, and the hemodynamics is stable during anesthesia. However, the risk of postoperative cardiac insufficiency was still higher than that of low altitude children, and the postoperative recovery time was prolonged.
【作者单位】：中南大学湘雅医院麻醉科;郑州大学第一附属医院麻醉科;
【基金】：国家自然科学基金(81370251,81501078)~~
【分类号】：R726.1

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