先天性心脏病患儿全身麻醉下口腔治疗的术前风险评估

doi:10.12337/zgkqjxjyzz.2023.06.004

中国口腔医学继续教育杂志 ›› 2023, Vol. 26 ›› Issue (6): 467-473.DOI: 10.12337/zgkqjxjyzz.2023.06.004

先天性心脏病患儿全身麻醉下口腔治疗的术前风险评估

罗林¹, 蒋琳琳¹, 杨燃², 吉阳^1,*

¹四川大学华西口腔医院麻醉科;
²四川大学华西口腔医院儿童口腔科

出版日期:2023-11-30 发布日期:2024-03-13
通讯作者: ^*吉阳,联系方式：028-85502116,电子邮箱：yangji7799@163.com,通讯地址：四川省成都市武侯区人民南路三段14号,610041

Preoperative Risk Evaluation for Children with Congenital Heart Disease Undergoing Dental Treatment Under General Anesthesia

Lin Luo¹, Linlin Jiang¹, Ran Yang², Yang Ji^1,*

¹Department of Anesthesiology, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan province, P.R. China;
²Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan province, P.R. China

Online:2023-11-30 Published:2024-03-13
Contact: ^*Yang Ji. Tel: 028-85502116. Emaill: yangji7799@163.com. Address: No. 14, Section 3, South Renmin Road, Wuhou District, Chengdu 610041, Sichuan Province, P.R. China.

摘要/Abstract

摘要： 先天性心脏病是儿科常见的先天性疾病之一,对全身麻醉的安全性存在潜在的影响,该类患儿围术期处理的难度远大于非先心病患儿。本文通过查阅文献,对该类患儿口腔治疗的术前风险评估与管理进行总结,表明先心病患儿围术期风险与先心病的种类和严重程度相关,术前须从症状、体征、辅助检查、心血管专科医师的建议等多方面综合考量。

关键词: 全身麻醉, 先天性心脏病, 儿童口腔, 风险, 口腔治疗

Abstract: Congenital heart disease (CHD) is one of the most common congenital diseases in children, and it shows a great influence on the safety of general anesthesia. Perioperative management of pediatric patients with CHD are much more difficult than normal pediatric patients. After literature review, the objective of this article is to provide an updated review on current preoperative risk evaluation of pediatric patients with CHD coming for pediatric dentistry. The results of the literature review show that perioperative risk of children with CHD is related to the type and severity of CHD. Symptoms, physical signs, laboratory examinations, advice from cardiovascular specialists, must be comprehensively considered before dental treatment.

Key words: anesthesia,general, heart defects,congenital, pediatric dentistry, risk, dental care

罗林, 蒋琳琳, 杨燃, 吉阳. 先天性心脏病患儿全身麻醉下口腔治疗的术前风险评估[J]. 中国口腔医学继续教育杂志, 2023, 26(6): 467-473.

Lin Luo, Linlin Jiang, Ran Yang, Yang Ji. Preoperative Risk Evaluation for Children with Congenital Heart Disease Undergoing Dental Treatment Under General Anesthesia[J]. Chinese Journal of Stomatological Continuing Education, 2023, 26(6): 467-473.

参考文献

[1] Seligman LD, Hovey JD, Chacon K, et al. Dental anxiety: An understudied problem in youth[J]. Clin Psychol Rev.2017 Jul; 55:25-40.
[2] Wu W, He J, Shao X. Incidence and mortality trend of congenital heart disease at the global, regional,national level, 1990-2017[J]. Medicine (Baltimore). 2020 Jun 5; 99(23):e20593.
[3] Nasr VG, Markham LW, Clay M, et al. Perioperative Considerations for Pediatric Patients with Congenital Heart Disease Presenting for Noncardiac Procedures: A Scientific Statement from the American Heart Association[J]. Circ Cardiovasc Qual Outcomes.2023 Jan; 16(1): e000113.
[4] Fraisse A, Latchman M, Sharma SR. Atrial septal defect closure: indications and contra-indications[J]. J Thorac Dis.2018 Sep;10(Suppl 24):S2874-S2881.
[5] Faraoni D, Zou X, DiNardo JA. Integration of the Intrinsic Surgical Risk With Patient Comorbidities and Severity of Congenital Cardiac Disease Does Not Improve Risk Stratification in Children Undergoing Noncardiac Surgery [J]. Anesth Analg.2020 Oct; 131(4):1083-1089.
[6] Nasr VG, França UL, Nathan M,et al. Patients With Congenital Heart Disease Undergoing Noncardiac Procedures at Hospitals With and Without a Cardiac Surgical Program[J]. J Am Heart Assoc.2022 Aug 2; 11(15):e026267.
[7] White MC. Approach to managing children with heart disease for noncardiac surgery[J]. Paediatr Anaesth.2011 May; 21(5):522-529.
[8] 朱鲜阳. 常见先心病介入治疗中国专家共识一、房间隔缺损介入治疗[J]. 介入放射学杂志, 2011, 20(01): 3-9.
[9] Saxena A, Relan J, Agarwal R, et al. Indian guidelines for indications and timing of intervention for common congenital heart diseases: Revised and updated consensus statement of the Working group on management of congenital heart diseases[J]. Ann Pediatr Cardiol.2019 Sep-Dec; 12(3):254-286.
[10] Tariq A, Bora V.Perioperative Management of Patients with Congenital Heart Disease[M]. StatPearls [Internet], Treasure Island (FL): StatPearls Publishing; 2023 Jan.
[11] Rao PS, Harris AD. Recent advances in managing septal defects: ventricular septal defects and atrioventricular septal defects[J]. F1000Res.2018 Apr 26; 7:F1000 Faculty Rev-498.
[12] 秦永文. 常见先心病介入治疗中国专家共识二、室间隔缺损介入治疗[J]. 介入放射学杂志, 2011, 20(02): 87-92.
[13] Schneider DJ, Moore JW. Patent Ductus Arteriosus[J]. Circulation.2006 Oct 24; 114:1873-1882.
[14] 朱鲜阳, 李奋. 常见先心病介入治疗中国专家共识四、经皮球囊肺动脉瓣与主动脉瓣成形术[J]. 介入放射学杂志, 2011, 20(04):253-259.
[15] Committee on Congenital Heart Diseases, Internal Medicine Branch of Cadiovascular Diseases, Chinese Physicians’Association. 常见先心病介入治疗中国专家共识五、先心病复合畸形的介入治疗[J]. 介入放射学杂志, 2011, 20(05):345-351.
[16] Doshi AR, Chikkabyrappa S. Coarctation of Aorta in Children[J]. Cureus.2018 Dec 5; 10(12):e3690.
[17] 张海波, 李守军. 先心病外科治疗中国专家共识(十一):主动脉缩窄与主动脉弓中断[J]. 中国胸心血管外科临床杂志, 2020, 27(11):1255-1261.
[18] Singh GK. Congenital Aortic Valve Stenosis[J]. Children (Basel). 2019 May 13; 6(5):69.
[19] 贾兵, 李守军. 先心病外科治疗中国专家共识(二):小儿先天性主动脉瓣狭窄[J]. 中国胸心血管外科临床杂志, 2020, 27(11):246-250.
[20] Watkins SC, McNew BS, Donahue BS. Risks of noncardiac operations and other procedures in children with complex congenital heart disease could assist clinicians in assessing perioperative risk[J]. Ann Thorac Surg.2013 Jan; 95(1):204-211.
[21] Ling Q, Gu Y, Chen JX,et al. Consequences of continuing renin angiotensin aldosterone system antagonists in the preoperative period: a systematic review and meta-analysis[J]. BMC Anesthesiol.2018 Feb 26; 18(1):26.
[22] Foz C, Peyton J, Staffa SJ, et al. Airway Abnormalities in Patients with Congenital Heart Disease: Incidence and Associated Factors[J]. J Cardiothorac Vasc Anesth.2021 Jan; 35(1):139-144.
[23] Hofler RC, Pecoraro N, Jones GA. Outcomes of Surgical Correction of Atlantoaxial Instability in Patients with Down Syndrome: Systematic Review and Meta-Analysis[J]. World Neurosurg.2019 Jun; 126:e125-e135.
[24] Benhaourech S, Drighil A, Hammiri AE. Congenital heart disease and Down syndrome: various aspects of a confirmed association[J]. Cardiovasc J Afr.2016 Sep/Oct; 27(5):287-290.
[25] Zabala LM, Guzzetta NA. Cyanotic congenital heart disease (CCHD): focus on hypoxemia, secondary erythrocytosis,coagulation alterations[J]. Paediatr Anaesth.2015 Oct; 25(10):981-989.
[26] Chubb H, Rosenthal E. Implantable cardioverter-defibrillators in congenital heart disease [J]. Herzschrittmacherther Elektrophysiol.2016 Jun; 27(2): 95-103.
[27] Fogel MA, Anwar S, Broberg C, et al. Society for Cardiovascular Magnetic Resonance/European Society of Cardiovascular Imaging/American Society of Echocardiography/Society for Pediatric Radiology/North American Society for Cardiovascular Imaging Guidelines for the Use of Cardiac Magnetic Resonance in Pediatric Congenital and Acquired Heart Disease: Endorsed by The American Heart Association[J]. Circ Cardiovasc Imaging.2022 Jun; 15(6):e014415.
[28] Sachdeva S, Gupta SK. Imaging Modalities in Congenital Heart Disease[J]. Indian J Pediatr.2020 May; 87(5):385-397.
[29] Menghraj SJ. Anaesthetic considerations in children with congenital heart disease undergoing non-cardiac surgery[J]. Indian J Anaesth.2012 Sep; 56(5):491-495.
[30] Diaz LK, Andropoulos DB. New developments in pediatric cardiac anesthesia[J]. Anesthesiol Clin North America.2005 Dec; 23(4):655-676, viii.
[31] Taylor D, Habre W.Risk associated with anesthesia for noncardiac surgery in children with congenital heart disease. Paediatr. Anaesth. 2019; 29(5):426-434.
[32] Brown ML, DiNardo JA, Nasr VG. Anesthesia in pediatric patients with congenital heart disease undergoing non-cardiac surgery: Defining the risk[J]. J. Cardiothorac Vasc Anesth. 2020; 34(2):470-478.
[33] Nasr VG, Staffa SJ, Faraoni D, et al. Trends in mortality rate in patients with congenital heart disease undergoing noncardiac surgical procedures at children’s hospitals[J]. Sci Rep.2021 Jan 15; 11(1):1543.

先天性心脏病患儿全身麻醉下口腔治疗的术前风险评估

Preoperative Risk Evaluation for Children with Congenital Heart Disease Undergoing Dental Treatment Under General Anesthesia

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 9

编辑推荐

Metrics

本文评价

[1]	张俸玮. 磁共振波谱对脑内代谢物检测的研究现状[J]. 中国口腔医学继续教育杂志, 2023, 26(6): 433-437.
[2]	高峰, 郁葱. 口腔门诊程序性镇静常用药物的研究进展[J]. 中国口腔医学继续教育杂志, 2023, 26(6): 459-466.
[3]	王沛娟, 刘冰, 吴宇飞, 张百泽, 张惠. 颅颌面发育畸形伴低龄儿童龋患儿全身麻醉下口腔治疗1例[J]. 中国口腔医学继续教育杂志, 2023, 26(6): 489-498.
[4]	罗岚瑞, 李楠, 杨爽, 刘克英, 朱洪平. 腭裂伴发屏气综合征及先心病1例[J]. 中国口腔医学继续教育杂志, 2023, 26(3): 227-232.
[5]	郭怡丹, 凌龙, 李静, 张笋. 疫情期间儿童口腔科线上教学效果与传统临床实习教学效果对比研究[J]. 中国口腔医学继续教育杂志, 2022, 25(1): 22-25.
[6]	朱信让, 袁璐, 王姣, 李志革. 规避下颌智齿拔除术中神经损伤风险的探讨[J]. 中国口腔医学继续教育杂志, 2021, 24(6): 367-370.
[7]	杨燃, 邹静, 黄睿洁. 儿童口腔医学进修医师综合能力的提升方案探究[J]. 中国口腔医学继续教育杂志, 2021, 24(3): 185-188.
[8]	张继伦. 一例低龄儿童龋的综合防治[J]. 中国口腔医学继续教育杂志, 2021, 24(2): 65-75.
[9]	张莉欣, 秦满. 儿童下牙槽神经阻滞麻醉不全及并发症的因素分析[J]. 中国口腔医学继续教育杂志, 2021, 24(2): 119-123.