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[低海拔地区藏族先天性心脏病患儿心脏手术及麻醉的围手术期安全性]

[Perioperative safety of Tibetan children with congenital heart disease undergoing cardiac surgery and anesthesia in low-altitude area].

作者信息

Pan Yundan, Niu Jiaojiao, Qin Gang, Wang Lu, Zhang Fan, Wang E

机构信息

Department of Anesthesiology, Xiangya Hospital, Central South University, Changsha 410008, China.

Department of Anesthesiology, First Affiliated Hospital, Zhengzhou University, Zhengzhou 450000, China.

出版信息

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2017 Nov 28;42(11):1288-1292. doi: 10.11817/j.issn.1672-7347.2017.11.008.

Abstract

To observe the clinical parameters and short-term prognosis of Tibetan high-altitude area children with congenital heart disease undergoing surgery and anaesthesia in low-altitude area, and to investigate the perioperative safety of the treatment.
 Methods: From January, 2016 to December, 2016, 14 children with congenital heart disease who underwent surgery were assigned into 2 groups (n=7 each): the high-altitude area group (X group, children from Tibetan Autonomous Region) and the low-altitude area group (H group, children from Hunan Province). Echocardiography data, perioperative hemodynamic changes, postoperative recovery, complication and perioperative serum N terminal pro B type natriuretic peptide (NT-proBNP) levels were recorded.
 Results: There were no significant differences in cardiac structure and function between the 2 groups, while the incidence of pulmonary hypertension in the X group was significantly higher than that in the H group (P<0.05). There were no significant differences in perioperative hemodynamics between the 2 groups (P>0.05), while the duration in ICU in the X group was longer than that in the H group and the serum NT-proBNP level in the X group was higher than that in the H group (P<0.05).
 Conclusion: For children with congenital heart disease in Tibetan high-altitude area, undergoing surgery in low-altitude area contributes to a steady perioperative hemodynamics and helps to increase the perioperative safety. There may be a higher risk of postoperative cardiac dysfunction in Tibetan children than that in low-altitude area.

摘要

观察西藏高海拔地区先天性心脏病患儿在低海拔地区接受手术及麻醉后的临床参数和短期预后,探讨该治疗的围手术期安全性。方法:选取2016年1月至2016年12月期间接受手术的14例先天性心脏病患儿,分为两组(每组n = 7):高海拔地区组(X组,来自西藏自治区的患儿)和低海拔地区组(H组,来自湖南省的患儿)。记录超声心动图数据、围手术期血流动力学变化、术后恢复情况、并发症及围手术期血清N末端B型利钠肽原(NT-proBNP)水平。结果:两组患儿心脏结构和功能无显著差异,但X组肺动脉高压发生率显著高于H组(P < 0.05)。两组围手术期血流动力学无显著差异(P > 0.05),但X组在重症监护病房(ICU)的停留时间长于H组,且X组血清NT-proBNP水平高于H组(P < 0.05)。结论:对于西藏高海拔地区先天性心脏病患儿,在低海拔地区进行手术有助于围手术期血流动力学稳定,提高围手术期安全性。西藏患儿术后发生心脏功能障碍的风险可能高于低海拔地区患儿。

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