本文關(guān)鍵詞： 超聲引導(dǎo) 先天性心臟病 經(jīng)皮介入術(shù) 麻醉管理　出處：《中國醫(yī)藥導(dǎo)報》2016年16期 　論文類型：期刊論文

【摘要】：目的探討單純超聲引導(dǎo)下先天性心臟病經(jīng)皮介入治療的麻醉管理策略。方法調(diào)取2014年9月~2015年6月在中國醫(yī)學(xué)科學(xué)院阜外醫(yī)院接受單純超聲引導(dǎo)下先天性心臟病經(jīng)皮介入治療患者的病歷資料,收集患者的性別、年齡、體重、疾病診斷、介入術(shù)時長以及麻醉管理相關(guān)數(shù)據(jù)。結(jié)果入選患者93例。動脈導(dǎo)管未閉[(3±1)歲]和肺動脈瓣狹窄[(3±2)歲]患者的年齡明顯低于房、室間隔缺損患者[(15±17)、(10±8)歲)]。室間隔缺損介入術(shù)的時長[(105±36)min]明顯長于房間隔缺損[(39±13)min]、動脈導(dǎo)管未閉[(47±11)min]和肺動脈瓣狹窄[(46±11)min]介入術(shù)的時長。73例小兒患者(≤12歲)中,33例(45.2%)使用喉罩、在局麻加靜吸復(fù)合麻醉下行經(jīng)皮介入治療,其余40例(54.8%)在局麻加靜脈麻醉下行經(jīng)皮介入治療。20例青少年和成人患者(12歲)均在局麻加靜脈麻醉下行經(jīng)皮介入治療。93例患者在介入治療術(shù)中均保留自主呼吸。氯胺酮適用于小兒,尤其是嬰幼兒患者,但肺動脈瓣狹窄的患者應(yīng)謹(jǐn)慎使用。丙泊酚適用于3歲以上患者。咪達(dá)唑侖、右美托咪定和七氟烷適用于各種年齡和疾病類型的患者。3例(3.2%)患者經(jīng)皮介入治療未成功,轉(zhuǎn)而在機(jī)械通氣下實(shí)施開胸手術(shù)。93例患者圍術(shù)期均未出現(xiàn)麻醉相關(guān)并發(fā)癥。結(jié)論應(yīng)根據(jù)患者年齡、疾病診斷以及經(jīng)皮介入治療術(shù)的復(fù)雜程度"個體化"選擇麻醉方式和使用麻醉藥物。
[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 鹵1] and pulmonary valve stenosis [3 鹵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 鹵36 minutes], patent ductus arteriosus [47 鹵11min] and pulmonary valve stenosis (46 鹵11min). Laryngeal mask was used in 33 of 73 children (鈮，

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