[1]蘆樹軍,劉云霞,喻文立,等.先天性膽道閉鎖合并卵圓孔未閉患兒肝移植圍術期血流動力學及心功能變化[J].醫學信息,2019,(20):95-97.[doi:10.3969/j.issn.1006-1959.2019.20.026]
 LU Shu-jun,LIU Yun-xia,YU Wen-li,et al.Changes of Hemodynamics and Cardiac Function During Liver Transplantation Period in Children with Congenital Biliary Atresia with Patent Foramen Ovale[J].Medical Information,2019,(20):95-97.[doi:10.3969/j.issn.1006-1959.2019.20.026]
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先天性膽道閉鎖合并卵圓孔未閉患兒肝移植圍術期血流動力學及心功能變化()
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醫學信息[ISSN:1006-1959/CN:61-1278/R]

卷:
期數:
2019年20期
頁碼:
95-97
欄目:
臨床研究
出版日期:
2019-10-15

文章信息/Info

Title:
Changes of Hemodynamics and Cardiac Function During Liver Transplantation Period in Children with Congenital Biliary Atresia with Patent Foramen Ovale
文章編號:
1006-1959(2019)20-0095-03
作者:
蘆樹軍劉云霞喻文立翁亦齊王清平賈莉莉
(天津市第一中心醫院麻醉科,天津 300192)
Author(s):
LU Shu-junLIU Yun-xiaYU Wen-liWENG Yi-qiWANG Qing-pingJIA Li-li
(Department of Anesthesiology,Tianjin First Central Hospital,Tianjin 300192,China)
關鍵詞:
小兒肝移植卵圓孔未閉血流動力學心功能
Keywords:
Pediatric liver transplantationPatent foramen ovaleHemodynamicsCardiac function
分類號:
R726
DOI:
10.3969/j.issn.1006-1959.2019.20.026
文獻標志碼:
A
摘要:
目的 探討合并卵圓孔未閉的先天性膽道閉鎖患兒行原位肝移植圍術期血流動力學及心功能的變化。方法 回顧性分析2017年2月~2019年2月我院擇期行原位肝移植術的先天性膽道閉鎖患兒69例,根據心臟多普勒彩超檢查結果分為卵圓孔未閉組(P組,卵圓孔>3 mm)27例和非卵圓孔未閉組(N組,卵圓孔≤3 mm)42例,比較兩組誘導插管后(T1),門靜脈阻斷即刻(T2),無肝期10 min(T3),門靜脈開放即刻(T4),新肝期1 h(T5),術畢(T6)時HR、MAP、CVP、SV、CO、CI、dp/dt和CCE及不良心血管事件發生率。結果 兩組T4時點MAP和CI低于T1時點,差異有統計學意義(P<0.05);兩組T2、T4時點SV和CO低于T1時點,T6時點SV和CO高于T1時點,差異有統計學意義(P<0.05);兩組T2~T6時點CCE低于T1時點,差異有統計學意義(P<0.05);兩組各時間點均未發生嚴重不良心血管事件。結論 與非卵圓孔未閉患兒比較,合并卵圓孔未閉的先天性膽道閉鎖患兒行原位肝移植圍術期血流動力學及心功能變化無差異,術前無明顯臨床癥狀或右向左分流致心功能不全,無需對卵圓孔未閉進行手術治療。
Abstract:
Objective To investigate the perioperative hemodynamics and cardiac function of orthotopic liver transplantation in children with congenital biliary atresia with patent foramen ovale. Methods A retrospective analysis of 69 children with congenital biliary atresia who underwent elective orthotopic liver transplantation in our hospital from February 2017 to February 2019 was performed,According to the Doppler color Doppler ultrasound examination results, the patients were divided into the foramen ovale group (P group, oval foramen > 3 mm), 27 cases, non-ovate foramen group (N group, oval foramen ≤ 3 mm) 42 cases,after induction of intubation (T1), portal vein blockade (T2), no hepatic phase 10 min (T3), portal vein open immediately (T4), new liver phase 1 h (T5), and surgery (T6) HR, MAP, CVP, SV, CO, CI, dp/dt, and CCE and incidence of adverse cardiovascular events. Results At the time of T4, the MAP and CI of the two groups were lower than the time of T1,the difference was statistically significant (P<0.05); the SV and CO at T2 and T4 were lower than T1, and the SV and CO were higher than T1 at T6, the difference was statistically significant (P<0.05). There was a statistically significant difference between the two groups at the time of T2~T6 when the CCE was lower than T1 (P<0.05). There were no serious adverse cardiovascular events at each time point. Conclusion Compared with non-ovate patients with patent foramen ovale, there is no difference in perioperative hemodynamics and cardiac function between children with congenital biliary atresia with patent foramen ovale. There is no obvious clinical symptoms before operation. Or right to left shunt to achieve cardiac insufficiency, no need for surgical treatment of patent foramen ovale.

參考文獻/References:

[1]Bacich D,Fiorencis A,Braggion G,et al.Patent foramen ovale-related complications in left ventricular assist device patients:a reappraisal for cardiovascular professionals[J].J Artif Organs,2019. [2]王衛利,高思楠,康一生,等.合并復雜先天性心臟病的兒童肝移植二例及文獻回顧[J].中華器官移植雜志,2018,6(39):359-363. [3]Alba AC,Verocai F,Granton J,et al.Patent foramen ovale does not have a negative impact on early out comes in patients undergoing liver transplantation[J].Clin Transplant,2011,25(1):151-155. [4]Concejero A,Chen CL,Liang CD,et al.Atrial septal defect in end-stage liver disease children before and after liver transplantation[J].Surgery,2008(143):271-277. [5]Werlang ME,Palmer WC,Boyd EA,et al.Patent foramen ovale in liver transplant recipients does not negatively impact short-term outcomes[J].Clin Transplant,2016(30):26-32.

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更新日期/Last Update: 2019-10-15
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