作　　者： ; ;

机构地区： 广东省人民医院

出　　处： 《国际儿科学杂志》 2018年第11期838-842,共5页

摘　　要： 先天性心脏病是最常见的先天性发育畸形,脑损伤是先心病术后最重要的并发症之一。先天性心脏病患儿出现脑损伤的机制是患者个体因素和环境影响复杂的相互作用的结果,包括不同的心脏畸形的关系、各种干预措施的影响,如心脏手术和围术期监护,也有显著的个体差异。虽然目前认为术前、术中和术后的脑缺血是复杂先天性心脏病脑损伤的主要机制,但住院期间和出院后的因素,也可能导致神经系统功能障碍。这些因素按照时间阶段大致可以分为三大类:宫内、围术期、出院后,这三类因素的相关作用是难以分开的,常常共同作用于同一患儿。系统地了解先天性心脏病儿童脑损伤的发生机制,对治疗和改善其远期预后有积极的意义。该文将就先天性心脏病儿童脑损伤的机制和病因作出综述。 Congenital heart disease is the most common congenital malformation.Neurodevelopmental disorder is one of the important complications of congenital heart disease.The mechanism of brain injury in CHD children is the result of complex interactions of individual factors and environmental effects,including different cardiac malformations,the effects of various interventions,such as cardiac surgery and perioperative care.Although preoperative,intraoperative and postoperative cerebral ischemia are known for the main mechanism of complex first-brain injury ,the factors during hospitalization and after discharge may be part of reason of neurological dysfunction in children with CHD.These factors can be roughly divided into three categories according to the stage:prenatal,perioperative and after,discharge.In fact,the correlation of these three factors is difficult to distinguish in the same patient.A better understanding of the pathogenesis of brain injury in children with congenital heart disease is of positive significance for the improvement of long-term prognosis.This article reviews the mechanism and etiology of brain injury in children with congenital heart disease.

关 键 词： 先天性心脏病 心脏手术 脑损伤 机制

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