儿童人工循环手术中呼吸窘迫综合征的诊断与治疗

Grudnaia khirurgiia (Moscow, Russia) Pub Date : 1989-09-01
Ia V Volkolakov, A T Latsis, Iu L Vater, L E Feldmane
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引用次数: 0

摘要

作者检查了152例先天性心脏病合并肺动脉高压的儿童。109例患者在低温灌注条件下进行手术,43例患者在体外循环条件下进行深度低温手术。呼吸机制紊乱和气体交换的结合被确定为呼吸窘迫综合征。肺扩张初始值与肺动脉高压程度成反比。随着肺动脉高压的升高,肺的扩张性降低,体外循环和气体交换变差。1.7 ~ 2.55 l/min/m2体积率的低温灌注导致术后早期肺膨胀性降低,力学和气体交换变差。在深度低温条件下进行手术的患者,肺扩张和气体交换的值是稳定的。低温灌注后呼吸窘迫综合征的发生率为56.3%,深低温后为7.2%。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Diagnosis and treatment of the respiratory distress syndrome during surgery in children under artificial circulation].

The authors examined 152 children with congenital heart diseases complicated by pulmonary hypertension. 109 patients were operated on under conditions of hypothermic perfusion and 43--under deep hypothermia with extracorporeal circulation. Combination of disturbed mechanics of respiration and gas exchange was determined as the respiratory distress syndrome. The initial value of lung expansibility was found to be in inverse proportion to the degree of pulmonary hypertension. With the increase of pulmonary hypertension lung expansibility reduced before extracorporeal circulation and gas exchange became worse. Hypothermic perfusion at volumetric rates of 1.7-2.55 l/min/m2 led to diminished lung expansibility in the early postperfusion period of the operation, the mechanics and gas exchange grew worse. In patients who underwent operation under conditions of deep hypothermia the values of lung expansibility and gas exchange were stable. The incidence of the respiratory distress syndrome was 56.3% after hypothermic perfusion and 7.2% after deep hypothermia.

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