2024 年第 5 期 第 0 卷

产时手术矫治危重先天性心脏病1例

Intrapartum treatment procedure for correction of critical congenital heart disease: a case report

作者：李刚1 赵举2 王晟3贺彦1 李燕娜4车辑5袁慧6王强1

英文作者：Li Gang1 Zhao Ju2 Wang Sheng3 He Yan1 Li Yanna4 Che Ji5 Yuan Hui6 Wang Qiang1

单位：1首都医科大学附属北京安贞医院小儿心脏中心，北京100029；2首都医科大学附属北京安贞医院重症医学中心，北京100029；3首都医科大学附属北京安贞医院麻醉中心，北京100029；4首都医科大学附属北京安贞医院妇产科，北京100029；5首都医科大学附属北京安贞医院输血科，北京100029；6首都医科大学附属北京安贞医院检验科，北京100029

英文单位：Congenital heart disease;Total anomalous pulmonary venous connection;Neonate

关键词：先天性心脏病；完全型肺静脉异位引流；新生儿

英文关键词：1PediatricCardiacCenter,BeijingAnzhenHospital,CapitalMedicalUniversity,Beijing100029,China;2CenterforCardiacIntensiveCare,BeijingAnzhenHospital,CapitalMedicalUniversity,Beijing100029,China;3AnesthesiaCenter,BeijingAnzhenHospital,CapitalMedicalUniversity,Beijing100029,China;4DepartmentofObstetricsandGynecology,BeijingAnzhenHospital,CapitalMedicalUniversity,Beijing100029,China;5DepartmentofTransfusion,BeijingAnzhenHospital,CapitalMedicalUniversity,Beijing100029,China;6DepartmentofClinicalLaboratory,BeijingAnzhenHospital,CapitalMedicalUniversity,Beijing100029,China

• 摘要：

• 危重先天性心脏病(先心病)患儿生后即面临生命危险，一旦病情恶化，预后极差。针对这种术后危重状态可能导致的严重不良后果，在1例入住首都医科大学附属北京安贞医院的胎儿心脏结构异常孕妇的诊疗中我们首次选择新生儿娩出后即启动手术的多学科救治模式，来规避术前的高风险。母孕期胎儿诊断为完全型肺静脉异位引流，于本院经剖宫产娩出胎儿后，立即转入心脏手术室，明确诊断，完成必要术前检查后开始麻醉，完成手术矫治，手术过程、术后恢复顺利。该救治模式通过新生儿娩出后即刻的早期手术有望改善危重先心病患儿的预后，降低死亡率，提高远期健康水平。

• Infants with critical congenital heart disease face life-threatening conditions immediately after birth. Once the condition worsens, the prognosis is extremely poor.In view of the serious adverse consequences that may result from this critical condition after surgery, in the diagnosis and treatment of a pregnant woman with abnormal cardiac structure of infant admitted to Beijing Anzhen Hospital, Capital Medical University, we chose the multidisciplinary treatment mode starting surgery immediately after delivery of neonate for the first time to avoid the high risk before surgery. The infant was diagnosed with total anomalous pulmonary venous connection during the mother′s pregnancy. After delivering the fetus through cesarean section in our hospital, she was immediately transferred to the cardiac operating room to confirm the diagnosis, complete the necessary preoperative examination, start anesthesia, complete surgical correction, and the operation process and postoperative recovery were smooth. This treatment approach, involving early postnatal surgery, holds the promise of improving the prognosis of infants with critical congenital heart disease, reducing mortality, and enhancing long-term health outcomes.