| 王显悦 毕生辉 王晓武 董文鹏 梁爱琼 徐宇 张卫达.血红蛋白200 g/L以上紫绀型先天性心脏病患者手术效果分析[J].,2014,14(7):1308-1311 |
| 血红蛋白200 g/L以上紫绀型先天性心脏病患者手术效果分析 |
| Operative Effects of Patients with Hemoglobin above 200 g/Lin Cyanotic Congenital Heart Disease |
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| DOI： |
| 中文关键词: 紫绀 血红蛋白 紫绀型先天性心脏病 手术 |
| 英文关键词: Cyanosis Hemoglobin Cyanotic congenital heart disease Operation |
| 基金项目:广州市科技计划项目（2011J4100021）；天普研究基金项目（01201122） |
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| 中文摘要: |
| 目的：明确血红蛋白200 g/L 以上紫绀型先天性心脏病患者的手术效果。方法：选取2009 年3 月至2012 年3 月于我中心
就诊手术治疗的紫绀型先天性心脏病患者，按血红蛋白计数逸200 g/L和＜200 g/L分为A 组和B 组，完善术前检查后进行手术
治疗。记录患者手术效果和随访情况；观察比较两组患者手术中情况包括：手术方式、手术时间、体外循环时间、心脏停搏时间、心
脏自动复跳情况；记录并比较两组患者手术后恢复情况，包括机械通气时间、监护室滞留时间、手术后24 小时内出血量、二次开
胸止血例数和血管活性药物评分，以及监护室内肝肾功能异常和肺部并发症发生例数。结果：A 组死亡3 例(5.2%)，23 例术后3
个月随访效果良好；B组死亡2 例(5.8%)，12 例术后3 个月随访效果良好。两组患者手术方式、手术时间、体外循环时间和心脏停
搏时间、自动复跳例数均无明显差异（P＞0.05）。与B组比较，A 组患者术后机械通气和监护室滞留时间长，术后24 小时出血量
多，血管活性药物使用评分高，肝肾功能异常例数和肺部并发症发生例数较多有统计学意义（P＜0.05），两组间二次开胸止血例数
无统计学差异（P＞0.05）。结论：血红蛋白200 g/L以上紫绀型先天性心脏病患者与其他紫绀型先天性心脏病患者手术效果相
似，但手术后恢复慢，并发症较多。 |
| 英文摘要: |
| Objective:To investigate operative effects of patients with hemoglobin above 200 g/L in cyanotic congenital heart
disease.Methods:From March 2009 through March 2012, patients with cyanotic congenital heart disease scheduled for operation were
grouped as A group (57 cases) andB group (34 cases) according to hemoglobin≥ 200 g/L or not, and operation performed after preoperative
examinations. Operative effects and follow up examinations in the two groups were observed. The records from two groups were
compared in terms of operative style and operating time, cardiopulmonary bypass time, cardiac arrest time, automatic cardioversion in
operation. The records of recovery from two groups were compared included ICU time, ventilation time, blood loss in first 24h after
operation, cases of second operation for bleeding, inotropic scores, liver and kidney dysfunction and pulmonary complications in ICU. Results:Three patients died in group A, and 23 cases had contented follow-up examinations 3 months later. Death accurred to 2 cases in
group B and 12 cases had satisfactory follow-up 3 months later. There was no statistical difference between the two groups as to
operative style , operating time, cardiopulmonary bypass time, cardiac arrest time and automatic cardioversion in operation（P＞0.05）.
Compared with group B, patients in group A had longer ICU time and ventilation time , more blood loss, higher inotropic scores, higher
frequency of liver and kidney dysfunction and pulmonary complications in ICU（P＜0.05）. There was no statistical difference between
the two groups in cases of second operation for bleeding.Conclusion:Patients with hemoglobin above 200 g/L posses a similar operative
effects to other patients with cyanotic congenital heart disease, but have longer recovery and more complications after operation. |
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