体外循环期间保持机械通气对学龄前先天性心脏畸形矫治术患儿术后肺部并发症发生率的影响

doi:10.3969/j.issn.1671-7171.2024.12.018

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Abstract 【Objective】To investigate the effects of mechanical ventilation during cardiopulmonary bypass (CPB) on postoperative pulmonary complications, arterial oxygenation and postoperative prognosis in pre-school children undergoing correction of congenital heart malformations. 【Methods】A total of 64 children undergoing lateral incision correction for congenital heart malformations in the Department of cardiothoracic Surgery of our hospital from July 2023 to July 2024 were prospectively selected and divided into the observation group (continued mechanical ventilation after upper and lower cavities were blocked during CPB) and the control group (no continued mechanical ventilation after upper and lower cavities were blocked during CPB) by random number table method, with 32 cases in each group. Perioperative indexes, postoperative pulmonary complications, and oxygenation index (PaO₂/FiO₂) at the beginning of CPB (T₀), occlusion of upper and lower vena cava (T₁), occlusion of aorta (T₂), end of CPB (T₃), end of surgery (T₄), and 1 h after surgery (T₅) were compared between the two groups. 【Results】The postoperative mechanical ventilation time and CCU residence time in the observation group were shorter than those in the control group, the levels of C-reactive protein and lactic acid were lower than those in the control group, and the postoperative vasoactive drug-positive inotropic drug score (VIS) was lower than those in the control group, with statistical significance (P<0.05). The incidence of PPCs in observation group was lower than that in the control group, and the difference was statistically significant (P<0.05). T₂, T₃, T₄, T₅, PaO₂/FiO₂ in the observation group were significantly higher than those in the control group, the difference was statistically significant (P<0.05). 【Conclusion】Mechanical ventilation during cardiopulmonary bypass can reduce the incidence of postoperative pulmonary complications and improve the prognosis of children undergoing correction of cardiac malformation.

Key words： Heart Defects, Congenital Cardiac Surgical Procedures Lung Diseases Postoperative Complications Respiration,Artificial

Received: 10 October 2024

PACS:

R725.411

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http://journal07.magtech.org.cn/yxlcyj/EN/10.3969/j.issn.1671-7171.2024.12.018 OR http://journal07.magtech.org.cn/yxlcyj/EN/Y2024/V41/I12/1889

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