快速康复在复杂先天性心脏病双向Glenn分流术中应用.docVIP

快速康复在复杂先天性心脏病双向Glenn分流术中应用 　　[摘要] 目的 探讨快速康复理念在复杂先天性心脏病双向Glenn分流术中的应用。 方法 回顾性分析本院2007年1月～2013年12月收治的49例复杂先天性心脏病患儿双向Glenn分流术的临床资料，2007年1月～2009年12月的21例为对照组，术后按常规处理，2010年1月～2013年12月的28例为快速康复组，术后采用快速康复理念进行临床处理，分析并比较两组患儿呼吸机辅助时间、ICU治疗时间，住院时间、早拔管率、再次气管插管率、肺部并发症发生率。 结果 两组患儿无住院死亡，均康复出院。快速康复组的呼吸机辅助时间、ICU治疗时间、住院时间短于对照组（P0.05）。 结论 快速康复在复杂先天性心脏病双向Glenn分流术患儿中应用安全、可行，能缩短患者的呼吸机辅助时间、ICU治疗时间和住院时间。 　　[关键词] 快速康复；先天性心脏病；双向Glenn分流术 　　[中图分类号] R654.2 [文献标识码] A [文章编号] 1674-4721（2015）02（b）-0035-05 　　1.Department of Cardiothoracic Surgery，the First Affiliated Hospital，Hunan University of Chinese Medicine，Changsha 410007，China；2.Department of Biochemistry and Molecular Biology，Hunan University of Chinese Medicine，Changsha 410208，China 　　[Abstract] Objective To investigate application of fast track in bi-directional Glenn shunt of congenital heart disease. Methods Clinical data of 49 patients following bi-directional Glenn shunt from January 2007 and December 2013 were retrospectively analyzed.Twenty-eight cases（fast track group）were treated with fast-track surgery and twenty-one cases（control group）were treated according to routine protocol in the perioperafive period.The time of mechainca ventilation，ICU treatment time and length of hospital stay，early extubation rate，reintubation rate，incidence rate of pulmonary complication in two groups were analyzed and compared. Results Two groups of children with no in-hospital death，all children rehabilitation hospital discharge.The time of mechainca ventilation，ICU treatment time and length of hospital stay in fast track group was shorter than that in control group respectively（P0.05）. Conclusion Fast track surgery in the perioperative period for patients with bi-directional Glenn shunt is safe and feasible，and can shorten the patient′s breathing machine auxiliary time，ICU stay time and hospitalization time. 　　[Key words] Fast track；Congenital heart disease；Bi-directional Glenn shunt 　　近年来，随着心脏外科手术技术、麻醉管理、体外循环以及术后重症监护水平的提高，先天性心脏病儿童术后生存与预后均得到显著改