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目的探讨10kg以下低体重婴幼儿先天性心脏病的外科治疗问题。方法自2000年1月至2007年12月,外科治疗10kg以下低体重婴幼儿先天性心脏病105例,体重3.5～10kg,年龄2个月至3岁,其中合并中度以上肺动脉高压和/或反复肺部感染史56例,复杂先天性心脏病35例。中度低温体外循环下手术88例,常温非体外循环心脏跳动下手术14例,深低温停循环选择性脑保护下手术3例;根治手术101例,姑息性手术4例。结果住院死亡5例(4.8%),存活100例,随访2月至3年,根治手术的97例中,室间隔缺损少量残余分流2例,无其他并发症和死亡,均生长发育良好,心功能I级;姑息手术的3例症状明显减轻。结论随着围术期管理、麻醉、体外循环和外科技术的提高,10kg以下低体重婴幼儿先天性心脏病外科治疗是安全的,临床效果良好。
Objective To investigate the surgical treatment of congenital heart disease in infants under 10kg. Methods From January 2000 to December 2007, 105 cases of congenital heart disease of infants weighing less than 10kg were treated surgically. The body weight was 3.5 ~ 10kg and ranged from 2 months to 3 years. The patients with moderate or severe pulmonary hypertension and / or 56 cases of recurrent lung infections, complicated congenital heart disease in 35 cases. There were 88 cases underwent moderate hypothermic cardiopulmonary bypass, 14 cases underwent cardiopulmonary bypass with beating heartbeat at room temperature, 3 cases under deep hypothermic circulatory arrest with selective cerebral protection, 101 cases under radical surgery and 4 cases under palliative surgery. Results There were 5 hospitalized deaths (4.8%) and 100 survived cases. Among the 97 patients who underwent radical operation in 2 months, a small residual shunt was found in 2 patients. There were no complications and deaths, Function level I; palliative surgery in 3 cases significantly reduced symptoms. Conclusion With the improvement of perioperative management, anesthesia, cardiopulmonary bypass and surgical techniques, surgical treatment of congenital heart disease in infants under 10kg is safe and the clinical effect is good.