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患儿心脏手术后一过性皮质盲——病例报告

Transient cortical blindness after heart surgery in a child patient -A case report-.

机构信息

Department of Anesthesiology and Pain Medicine, College of Medicine, Chungbuk National University, Cheongju, Korea.

出版信息

Korean J Anesthesiol. 2010 Jul;59(1):61-4. doi: 10.4097/kjae.2010.59.1.61. Epub 2010 Jul 21.

Abstract

Visual loss occurring after pediatric cardiac surgery employing cardiopulmonary bypass (CPB) is relatively rare but the risk is substantial. Compromised cerebral perfusion due to a CPB related micro-embolization and inflammatory vascular changes as well as reduced oxygen carrying capacity in hemodilution and hypothermia during CPB might be major contributing factors to the development of postoperative visual loss after cardiac surgery with CPB. A case of immediate but transient postoperative visual loss was encountered in a 21-month-old male who underwent tricuspid valve surgery. Despite routine intraoperative measures to maintain an adequate perfusion pressure throughout the procedure, postoperative computed tomography revealed a subacute infarct in his occipital lobe. Recovery began on postoperative day 28, and the patient's vision was restored by 31 days.

摘要

小儿心脏体外循环(CPB)术后发生视力丧失相对罕见,但风险很大。CPB 相关微栓塞和炎症性血管变化导致脑灌注受损,以及血液稀释和 CPB 期间低温导致携氧能力降低,可能是 CPB 心脏手术后发生术后视力丧失的主要因素。一名 21 个月大的男性在接受三尖瓣手术后出现了立即但短暂的术后视力丧失。尽管在整个手术过程中采取了常规的术中措施来维持足够的灌注压,但术后计算机断层扫描显示他的枕叶有亚急性梗死。术后第 28 天开始恢复,患者的视力在第 31 天恢复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b8b/2908231/49a1c2eb5feb/kjae-59-61-g001.jpg

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