凝血后心脏手术干预患儿的处理策略

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引用次数: 0

摘要

背景:先天性心脏病患儿在接受复杂的小儿心脏手术合并体外循环(CPB)时,由于术后出血而导致相当高的术后死亡率和发病率。凝血系统受损是儿童心脏手术后出血过多的主要原因。目的:探讨小儿心脏手术后凝血功能障碍的不同治疗方法。方法:检索Pubmed、Web of Science、Scopus、Embase、SpringerLink和Cochrane Library,查找与该主题相关的各种文章。搜索策略;(心脏外科)和(儿科)和(凝血功能障碍)和(术后)。调查于2022年4月结束。科学新颖性:凝血后心脏手术是一个相对较新的医学领域,在过去十年中取得了巨大的进步。它包括使用专门的技术来减少心脏手术期间和之后出血的风险。这包括使用抗凝剂、溶栓剂和其他药物来减少凝血和改善预后。此外,诸如机器人辅助手术之类的新技术已经被开发出来,以提高心脏手术的精度和准确性。因此,本综述旨在探讨治疗凝血功能障碍心脏手术后儿童患者的策略。结论:由于儿童凝血功能障碍心脏手术后儿童患者独特的生理和解剖结构,其治疗是一个特别具有挑战性的领域。因此,需要新的方法来确保这些患者的最佳结果。例如,研究表明,抗凝剂与溶栓剂联合使用可以降低儿科患者心脏手术后出血并发症的风险。
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Tactics of managing children-patients with post-coagulopathy cardiac surgery interventions
Background: Children with congenital heart disease undergoing complicated pediatric cardiac surgery with cardiopulmonary bypass (CPB) experience considerable post-operative mortality and morbidity due to post-operative bleeding. An impairment in the blood clotting system primarily contributes to excessive bleeding in children following heart surgery. Aim: to assess the different methods for the treatment of pediatric patients with post-coagulopathy cardiac surgery. Methods: Pubmed, Web of Science, Scopus, Embase, SpringerLink, and the Cochrane Library in order to find various articles concerning this topic were searched. The search strategy; (cardiac surgery) AND (pediatric) AND (coagulopathy) AND (post-operative) was used. The investigation ended in April 2022. Scientific novelty: Post-coagulopathy cardiac surgery is a relatively new medical field that has seen tremendous advances in the past decade. It involves the use of specialised techniques to reduce the risk of bleeding during and after cardiac surgery. This includes the use of anticoagulants, thrombolytics, and other medications to reduce clotting and improve outcomes. In addition, newer technologies such as robotic-assisted surgery have been developed to improve precision and accuracy during cardiac procedures. Therefore, this review aims to address the tactics of managing children-patients with post-coagulopathy cardiac surgery Conclusion: The management of children-patients with post-coagulopathy cardiac surgery is a particularly challenging area due to their unique physiology and anatomy. As such, there is a need for novel approaches to ensure optimal outcomes for these patients. For example, research has shown that using anticoagulants in combination with thrombolytics can reduce the risk of bleeding complications following cardiac surgery in pediatric patients.
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