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[施耐德儿童医学中心术后心脏监护病房的第一年经验]

[First year's experience of the Post-Operative Cardiac Care Unit, Schneider Children's Medical Center].

作者信息

Dagan O, Birk E, Katz J, Vidne B

机构信息

Cardiothoracic Pediatric Service, Schneider Children's Medical Center, Petah Tikva.

出版信息

Harefuah. 1998 Jan 15;134(2):101-5.

PMID:9517291
Abstract

In the past 10 years there has been a growing preference for early, complete correction of congenital heart disease. The first year of operation of this cardiac unit is described. 216 operations were performed: 15% in the neonatal age group and 35% in the newborn to 1-year-old groups; 2% were palliative procedures. Mortality was 4.9%. Average stay in the ICU was 3.2 days, with a median of 2.25. Average length of ventilation was 35 hours, with a median of 17.5. Complications were: diaphragm paralysis in 13 (6%), 2/3 of which were recurrent operations; in 2 patients (0.9%) we had to plicate the diaphragm. There was severe neurological damage in 2 which deteriorated to brain death in 1. There was peripheral, reversible neurological damage in 4 (1.8%), and acute renal failure in 3%, with half of them requiring dialysis. 75% of these children died and there was superficial infection in 4.1%, deep wound infection in 1.3%, bacteremia in 4.1%, superior vena cava syndrome in 3 (1.3%) and chylothorax in 2 of them (0.9%). 1 patient (0.45%) required a ventricle-peritoneal shunt after acute viral meningitis. We are encouraged by our results to offer early complete correction to all children with congenital heart disease.

摘要

在过去10年里,对于先天性心脏病早期进行彻底矫正的偏好日益增加。本文描述了该心脏科第一年的手术情况。共进行了216例手术:新生儿年龄组占15%,新生儿至1岁年龄组占35%;2%为姑息性手术。死亡率为4.9%。在重症监护病房(ICU)的平均住院时间为3.2天,中位数为2.25天。平均通气时间为35小时,中位数为17.5小时。并发症包括:13例(6%)出现膈神经麻痹,其中2/3为再次手术;2例患者(0.9%)需要对膈肌进行折叠术。2例出现严重神经损伤,其中1例恶化至脑死亡。4例(1.8%)出现周围性、可逆性神经损伤,3%出现急性肾衰竭,其中一半需要透析。这些儿童中有75%死亡,4.1%出现浅表感染,1.3%出现深部伤口感染,4.1%出现菌血症,3例(1.3%)出现上腔静脉综合征,其中2例(0.9%)出现乳糜胸。1例患者(0.45%)在急性病毒性脑膜炎后需要进行脑室-腹腔分流术。我们对结果感到鼓舞,因此为所有先天性心脏病患儿提供早期彻底矫正治疗。

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