单纯超声引导下先天性心脏病经皮介入治疗的麻醉管理

发布时间：2018-02-27 22:19

  本文关键词： 超声引导 先天性心脏病 经皮介入术 麻醉管理　出处：《中国医药导报》2016年16期 　论文类型：期刊论文

【摘要】：目的探讨单纯超声引导下先天性心脏病经皮介入治疗的麻醉管理策略。方法调取2014年9月~2015年6月在中国医学科学院阜外医院接受单纯超声引导下先天性心脏病经皮介入治疗患者的病历资料,收集患者的性别、年龄、体重、疾病诊断、介入术时长以及麻醉管理相关数据。结果入选患者93例。动脉导管未闭[(3±1)岁]和肺动脉瓣狭窄[(3±2)岁]患者的年龄明显低于房、室间隔缺损患者[(15±17)、(10±8)岁)]。室间隔缺损介入术的时长[(105±36)min]明显长于房间隔缺损[(39±13)min]、动脉导管未闭[(47±11)min]和肺动脉瓣狭窄[(46±11)min]介入术的时长。73例小儿患者(≤12岁)中,33例(45.2%)使用喉罩、在局麻加静吸复合麻醉下行经皮介入治疗,其余40例(54.8%)在局麻加静脉麻醉下行经皮介入治疗。20例青少年和成人患者(12岁)均在局麻加静脉麻醉下行经皮介入治疗。93例患者在介入治疗术中均保留自主呼吸。氯胺酮适用于小儿,尤其是婴幼儿患者,但肺动脉瓣狭窄的患者应谨慎使用。丙泊酚适用于3岁以上患者。咪达唑仑、右美托咪定和七氟烷适用于各种年龄和疾病类型的患者。3例(3.2%)患者经皮介入治疗未成功,转而在机械通气下实施开胸手术。93例患者围术期均未出现麻醉相关并发症。结论应根据患者年龄、疾病诊断以及经皮介入治疗术的复杂程度"个体化"选择麻醉方式和使用麻醉药物。
[Abstract]:Objective to explore the anesthetic management strategy of percutaneous interventional therapy for congenital heart disease under the guidance of simple ultrasound. Methods from September 2014 to June 2015, congenital heart disease under the guidance of pure ultrasound was obtained from Fuwei Hospital, Chinese Academy of Medical Sciences. Medical records of patients undergoing percutaneous interventional therapy, Data on sex, age, body weight, disease diagnosis, duration of interventional procedure and anesthesia management were collected. Results the age of patients with patent ductus arteriosus [3 卤1] and pulmonary valve stenosis [3 卤2] years was significantly lower than that of atrium. The duration of interventional procedures for ventricular septal defect (VSD) was significantly longer than that for atrial septal defect (ASD) [105 卤36 minutes], patent ductus arteriosus [47 卤11min] and pulmonary valve stenosis (46 卤11min). Laryngeal mask was used in 33 of 73 children (鈮，

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