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升主动脉发出右肺动脉为罕见之先天性心脏病,多在新生儿期或婴儿期发生心肺功能不全,预后不良。作者报告1例合并多器官衰竭患儿2次手术的麻醉经验。男婴,2月龄,身长54.5cm,体重3.9kg。因生后月余出现呼吸气促,紫绀、消化不良等症状入院。胸片示心脏扩大,肺淤血。经超声、心导管检查确诊为升主动脉发出右肺动脉畸形合并卵圆孔未闭。心导管检查后次日突然心跳停止,经复苏成功。考虑心功能不全而使用儿茶酚胺类药和扩血管药。为限制肺血流量,调节PaO_2于40
Ascending aorta issued right pulmonary artery is a rare congenital heart disease, and more in neonatal or infancy cardiopulmonary insufficiency, poor prognosis. The authors report 1 case of anesthesia with 2 surgeries in children with multiple organ failure. Baby boy, 2 months old, body length 54.5cm, weight 3.9kg. Due to postpartum respiratory arrest, cyanosis, indigestion and other symptoms admitted to hospital. Chest radiograph showed heart enlargement, pulmonary congestion. The ultrasound, cardiac catheterization diagnosed ascending aorta issued right pulmonary artery anomalies with patent foramen ovale. Cardiac catheterization suddenly stopped the next day after a successful recovery. Consider cardiac insufficiency and use of catecholamines and vasodilators. To limit pulmonary blood flow, adjust PaO_2 at 40