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頁籤選單縮合
題名 | Profound Hypoxemia during Major Abdominal Surgery in a Small Infant with Tetralogy of Fallot=一法洛氏四重症嬰兒於大腹部手術中發生嚴重血氧飽和度下降 |
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作者 | 黃潔文; 黃樹欽; 蔡時彰; 高宜娟; 賴勁堯; Wong, Teresa Kit-man; Wong, Shu-yam; Tsai, Shih-chang; Kau, Yi-chuan; Lai, Jin-yao; |
期刊 | 長庚醫學 |
出版日期 | 20050700 |
卷期 | 28:7 2005.07[民94.07] |
頁次 | 頁498-502 |
分類號 | 417.5223 |
語文 | eng |
關鍵詞 | 法洛氏四重症; 嚴重缺氧; 腹部手術; Tetralogy of Fallot; Profound hypoxemia; Major abdominal surgery; |
中文摘要 | 報告一兩個月大、患有法洛氏四重症先天性心臟病之嬰兒,因巨大結腸症進行pull through手術中發生嚴重血氧飽和度下降情形。手術進行至腹腔內臟往外翻出後病人發生嚴重血氧飽和度下儀、持續約120分鐘之久。缺氧情形於內臟放回復腔後完全獲得改善。發生原因推想可能為內臟往外翻出後腹壓降低,體循環阻力突然減低,加上體溫低、酸血等因素,使從右至左上液分流變得很厲害,因而發生嚴重血氧飽和度下降情形。術後病人沒有明顯神經系統方面受傷情形建議有嚴重先天發紺或心臟病人,進行大型侵犯性之腹部手術術前應予以慎重評估。 |
英文摘要 | We report a protracted hypoxic event during Soave’s endorectal pull-through for Hirschsprung’s disease in a 2-month-old male infant with tetralogy of Fallot. After the bowel loops were delivered out of the abdominal cavity, profound hypoxemia occurred which persisted for about 120 min. The hypoxemia was completely resolved after the intestine was reduced back into the peritoneal cavity. The immediate cause was postulated to have been decreased systemic vascular resistance. Associated factors included hypothermia and acidosis leading to high pulmonary vascular resistance which further aggravated the right-to-left blood-shunting situation in this patient. Postoperative follow-up showed no neurological complications. Small infants with complex heart disease should be carefully evaluated before major abdominal surgery. |
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