小儿心脏手术后早期心律失常

K. Hoque, Akhand Tanzih Sultana, Mamun Mia, M. Chowdhury, M. Hossein
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引用次数: 2

摘要

背景:儿科心脏手术技术的根本性改变极大地降低了发病率和死亡率。在我国,术后经常观察到的各种心律失常仍然没有很好的记录。目的:确定儿科年龄组心脏手术后心律失常的发生率和危险因素。材料和方法:这是一项前瞻性研究。有目的地选择了2013年至2016年间在达卡石树医院接受心脏手术的100名儿科患者(年龄<18岁)。结果:在100名患者中,最大41%来自13-72个月年龄组。平均年龄为49.73±37.17个月,年龄范围为0.5-231个月,58%为男性,其余为女性。术后31%的受试者出现心律失常,其中交界性异位性心动过速患者最多。在这100名患者中,39%被诊断为室间隔缺损,随后是TOF(35%)。31例心律失常患者中,术后1、1~2、2~7期心律失常发生率分别为59.83%、41.93%和3.22%。在本研究中,年龄、体重、发绀、CPB时间、术后酸中毒、通气支持天数、,结论:对年龄较小、体重较低的年轻患者进行适当、仔细的监测,延长体外循环时间,可减少术后心律失常的发生。这些患者术后可能需要高度的肌力支持。因此,医学预防和早期诊断以及适当的管理可以提高手术效果。德尔塔医学杂志2018年1月6(1):22-28
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Early Postoperative Arrhythmias after Paediatric Cardiac Surgery
Background: The radical change in techniques in paediatric cardiac surgery has dramatically reduced the morbidity and mortality. The different varieties of arrhythmia that are frequently observed in postoperative period in our country are still not well documented.Objectives: To determine the incidence and risk factors of arrhythmia immediately after cardiac surgery in paediatric age group.Materials and method: It was a prospective study. A total of 100 paediatric patients (age <18 years) who underwent cardiac surgery at Dhaka Shishu Hospital between 2013 and 2016 were selected purposivelyResults: Out of 100 patients maximum 41% were from 13-72 months age group. The mean age was 49.73±37.17 months with range of 0.5-231 months, 58% patients were male and rest were female. Postoperatively 31% subjects were arrhythmic and of these the highest number of patients suffered from junctional ectopic tachycardia. Out of these 100 patients, 39% were diagnosed as VSD followed by TOF (35%). Among 31 arrhythmic patients 59.83%, 41.93% and 3.22% manifested onset of arrhythmia at 1st, 1st to 2nd and 2nd to 7th postoperative period respectively. In this study age, body weight, cyanosis, CPB time, postoperative acidosis, ventilation support days, hypertension on arrival in ICU as well as ICU stay days were recognized as significant risk factors (p <0.05).Conclusion: Proper and careful monitoring of younger patient with lower body weight undergoing corrective cardiac surgery with long cardiopulmonary bypass (CPB) time may reduce the episodes of post operative arrhythmia. These patients may require high inotropic support post operatively. So, medical prevention and early diagnosis as well as proper management may improve the operative outcome.Delta Med Col J. Jan 2018 6(1): 22-28
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