小儿心脏麻醉手册
小儿心脏麻醉手册
2.图文并茂，尤其是彩图，比较生动准确地反映了先天性心脏病的病理解剖，病理生理改变及手术治疗方案，对正确理解小儿心脏麻醉的管理起到了肺常重要的作用。
3.简明扼要，重点难度突出，既有深度又有广度。 内容简...
2.图文并茂，尤其是彩图，比较生动准确地反映了先天性心脏病的病理解剖，病理生理改变及手术治疗方案，对正确理解小儿心脏麻醉的管理起到了肺常重要的作用。
3.简明扼要，重点难度突出，既有深度又有广度。
第 1 章 心血管系统的发育 ……………………………………………………………3
胚胎发育 / 3
心血管生理 / 3
第 2 章 先天性心脏病中的重要概念 …………………………………………………9
先天性心脏病的病理生理 / 9
肺血管的病理生理 / 18
肺血管阻力的调控 / 19
心肌缺血 / 21
第 3 章 术前评估 ……………………………………………………………………… 23
临床病史 / 23
受郑吉建教授的委托，让我为这本《The Pediatric Cardiac AnesthesiaHandbook》中文版写序，并将原版书借我阅读。阅后我感觉尽管书名叫《小儿心脏
麻醉手册》，比较低调，但内容十分丰富和全面。美国哈佛医学院波士顿儿童医院小儿心血管专业近年来一直在全美排名前列。原书作者是长期从事小儿心血管麻
醉的临床专家，拥有丰富的临床实践经验，把小儿先心病的许多基本概念包括解剖和血流动力学特征描述得简明扼要，清晰易懂，而且注重对先心患儿的术前评估、
术中监测和术后管理。
本书分为两大部分。部分为基础内容，着重介绍有关小儿先心病的胚胎发育和病理生理特点，同时还介绍了体外循环、机械辅助循环以及心导管等方面的相
关知识。第二部分介绍了20余种常见先心病的解剖特征、手术处理原则和麻醉管理特点，言简意赅，图文并茂，十分易于理解。相信该书不管是对从事小儿心血管麻
醉的专业人员，还是对心脏内科、心脏外科医师以及监护室的医师和护士，都会有很大的帮助作用。
我院小儿心血管专业的建设和发展，是一个团队合作建设的过程。记得20世纪70年代创业初期，正是由金熊元教授、鲍泽民教授、马家骏教授、陈煜教授等几代
的。药物、病毒感染、母亲患有糖尿病或酗酒等外界因素可导致某些特定缺陷。要掌握先天性心脏病，就必须了解心脏发育相
关的基础知识。本章主要对胚胎发育及出生时的心血管生理进行简要概述。
胚胎发育
要深入领会本手册后续篇章所讲述的特定先天性心脏病，就必须首先了解心脏结构的起源和胚胎发育的基础知识。以下
心脏发育的具体细节已超出本手册的讨论范畴：① 心脏偏侧（cardiac sidedness）或不对称；② 心袢形成（cardiac looping）；③ 流
出道形成；④ 心脏分隔。心脏、血管的胚胎结构和与之对应的成熟结构见表1 — 1。新生儿出生时，其血液循环就开始发
生变化，而且变化非常明显，持续数日到数月。血液循环的变化对新生儿心血管生理的影响比较广泛，值得特别关注。约50%
的先天性心脏病患儿在出生后数日或数周就需要内科或外科手术干预，这并非巧合。
CHD新生儿的围术期治疗及麻醉管理方案的制订，必须建立在充分了解这些发育改变的基础上。
胎儿循环
胎儿的循环通道使血液不流经肺脏，这样左右心室将血液共同泵入体循环动脉系统，提供全身氧供。这一并联循环模式甚至可以使患有心脏病的胎儿正常生长和
发育。
来自胎盘的氧合血通过脐静脉和门静脉回到胎儿体内。静脉导管在其与下腔静脉（IVC）连接处与左侧门静脉和左侧肝静
脉相连。约有50%的脐静脉血不经肝窦直接进入IVC，其余的脐静脉血回流到肝脏，再经肝静脉进入IVC。胎儿的IVC血来自
胎儿的下半身、脐静脉及肝静脉。在下腔静脉中，来自静脉导管的血流速度比来自胎儿下半身和肝静脉的血流快，这有利于
将富含氧的血经卵圆孔（FO）运输到左心房（LA）（图1 — 1）。由于欧氏瓣（Eustachian valve）、希阿里网（Chiari network）和卵圆孔的位置关
系，下腔静脉血经右心房（RA）进入LA的时间占整个心动周期的80%。IVC血经三尖瓣进入右心室（RV）的时间占心动周
期的20%（心房收缩）。绝大部分来自上腔静脉（SVC）的血液也通过三尖瓣进入右心室。右心室射血到肺动脉（PA）。约
Shipping Overview:
• Shipping: Standard Domestic Shipping within the United States charges USD 4.99. Standard International Shipping from United Kingdom and Germany to the United States charges 14.99.
• Order Processing: Please allow 1-2 business days for order processing and preparation before shipment.
• Domestic Shipping: Orders within the U.S. are shipped via USPS or FedEx, depending on the origin of the product. The average transit time is 3-7 business days.
• International Shipping: Currently, we only ship within the USA.
• Tracking Information: Every order is trackable. You will receive a tracking number once your order has been shipped. Products may be shipped from various global fulfillment centers.
Shipping Delays:
Please note that shipping times may vary due to factors beyond our control, such as weather conditions, natural disasters, or peak holiday periods. While we strive to ensure timely delivery, the exact arrival time cannot be guaranteed and is managed by the shipping carrier.
Shipping Options:
-
Standard Delivery: Most orders are shipped within 3-7 business days. Larger items may utilize LTL shipping for safe handling.
-
Handling Time: We handle shipments on business days (Monday - Friday), with a preparation time of 1-2 days.
-
Additional Charges: Some items require additional shipping charges due to their size, weight, or special handling. These charges are specified on the product pages and are not eligible for shipping discounts.
-
Exclusions: Gift cards, packaging, taxes, and prior purchases do not count toward the minimum purchase requirement for free shipping. This offer is valid only for shipments to U.S. addresses, including Puerto Rico.
Delivery Details:
-
Estimates: Standard shipping within the US typically takes 3-7 business days. These are estimates and not guarantees.
-
Shipping Restrictions: We ship to all 50 states, Washington, DC, U.S. territories, and APO/FPO/DPO addresses. Shipping options vary based on the delivery address.
-
Remote Areas: Shipments to remote areas may incur additional charges or require pickup from a nearby shipping partner’s location.
Shipping Confirmation:
You will receive a shipping confirmation email with a tracking number as soon as your order is dispatched. If you do not receive this email immediately, please be assured that your items will arrive within the estimated delivery window provided at checkout.
Order Modifications:
If you need to cancel or modify your order, please contact our customer support immediately.
Issues with Delivery:
If your order shows as delivered but you have not received it, please contact the shipping carrier directly to resolve the issue. For persistent problems, contact our customer service at cs@everymarket.com.
Customer Support:
Our team is available 24/7 to assist you with any questions or concerns regarding your order. We are committed to ensuring a smooth shopping experience.
Return & Refund Policy Overview
Please review our return and refund policies below to ensure a smooth transaction process.
Return Policy
-
Duration: You have 30 days from receiving your item to initiate a return.
-
Condition: Items must be unworn, unwashed, with original tags and packaging intact.
-
Shipping Costs: Customers are responsible for return shipping costs.
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Packaging: Ensure returned items are well-packaged to avoid damage during transit.
-
Tracking: Use a trackable and insured shipping method as we are not liable for items lost or damaged on return.
-
Initiating a Return: Contact us at cs@everymarket.com to start your return. We will provide a return shipping label and instructions upon approval. Returns without prior approval will not be accepted.
How to Return
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Method: Returns must be sent back by mail to the address provided in the return instructions.
Return Label
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Defective Products: Return labels are provided for defective items.
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Non-Defective Returns: Customers are responsible for obtaining their return shipping label.
Product Conditions for Return
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Eligible Products: Returns are only accepted for items in new condition.
Nonreturnable Items
Certain items are not eligible for return:
-
Electronic devices after 30 days (e.g., computers, laptops, Kindles)
-
Gift cards, prepaid game cards
-
Perishable goods, live insects, some jewelry, some health and personal care items
-
Customized or personalized products
-
Items with special shipping restrictions
Refund Policy
-
Window: Eligible products may be returned within 30 days of delivery for a refund.
-
Refund Method: Refunds are processed to the original payment method or as store credit for items purchased with gift cards.
-
Processing Time: Refunds are processed within 3-5 business days after we receive the return; please allow additional time for shipping and bank processing.
Claims
Inspect your order upon arrival and report any defects, damages, or incorrect items immediately to allow us to address the issue. For claims, contact our support team with details of the issue.
Exchange Policy
For the quickest service, return your original item and place a new order for the desired product once your return is accepted.
Return Address
EveryMarket Customer Service 2101 E Terra Ln, O'Fallon, MO 63366
Customer Support
Available 24/7 for any questions or assistance needed:
-
Phone: +1 636-312-5925
-
Email: cs@everymarket.com
2.图文并茂，尤其是彩图，比较生动准确地反映了先天性心脏病的病理解剖，病理生理改变及手术治疗方案，对正确理解小儿心脏麻醉的管理起到了肺常重要的作用。
3.简明扼要，重点难度突出，既有深度又有广度。
第 1 章 心血管系统的发育 ……………………………………………………………3
胚胎发育 / 3
心血管生理 / 3
第 2 章 先天性心脏病中的重要概念 …………………………………………………9
先天性心脏病的病理生理 / 9
肺血管的病理生理 / 18
肺血管阻力的调控 / 19
心肌缺血 / 21
第 3 章 术前评估 ……………………………………………………………………… 23
临床病史 / 23
受郑吉建教授的委托，让我为这本《The Pediatric Cardiac AnesthesiaHandbook》中文版写序，并将原版书借我阅读。阅后我感觉尽管书名叫《小儿心脏
麻醉手册》，比较低调，但内容十分丰富和全面。美国哈佛医学院波士顿儿童医院小儿心血管专业近年来一直在全美排名前列。原书作者是长期从事小儿心血管麻
醉的临床专家，拥有丰富的临床实践经验，把小儿先心病的许多基本概念包括解剖和血流动力学特征描述得简明扼要，清晰易懂，而且注重对先心患儿的术前评估、
术中监测和术后管理。
本书分为两大部分。部分为基础内容，着重介绍有关小儿先心病的胚胎发育和病理生理特点，同时还介绍了体外循环、机械辅助循环以及心导管等方面的相
关知识。第二部分介绍了20余种常见先心病的解剖特征、手术处理原则和麻醉管理特点，言简意赅，图文并茂，十分易于理解。相信该书不管是对从事小儿心血管麻
醉的专业人员，还是对心脏内科、心脏外科医师以及监护室的医师和护士，都会有很大的帮助作用。
我院小儿心血管专业的建设和发展，是一个团队合作建设的过程。记得20世纪70年代创业初期，正是由金熊元教授、鲍泽民教授、马家骏教授、陈煜教授等几代
的。药物、病毒感染、母亲患有糖尿病或酗酒等外界因素可导致某些特定缺陷。要掌握先天性心脏病，就必须了解心脏发育相
关的基础知识。本章主要对胚胎发育及出生时的心血管生理进行简要概述。
胚胎发育
要深入领会本手册后续篇章所讲述的特定先天性心脏病，就必须首先了解心脏结构的起源和胚胎发育的基础知识。以下
心脏发育的具体细节已超出本手册的讨论范畴：① 心脏偏侧（cardiac sidedness）或不对称；② 心袢形成（cardiac looping）；③ 流
出道形成；④ 心脏分隔。心脏、血管的胚胎结构和与之对应的成熟结构见表1 — 1。新生儿出生时，其血液循环就开始发
生变化，而且变化非常明显，持续数日到数月。血液循环的变化对新生儿心血管生理的影响比较广泛，值得特别关注。约50%
的先天性心脏病患儿在出生后数日或数周就需要内科或外科手术干预，这并非巧合。
CHD新生儿的围术期治疗及麻醉管理方案的制订，必须建立在充分了解这些发育改变的基础上。
胎儿循环
胎儿的循环通道使血液不流经肺脏，这样左右心室将血液共同泵入体循环动脉系统，提供全身氧供。这一并联循环模式甚至可以使患有心脏病的胎儿正常生长和
发育。
来自胎盘的氧合血通过脐静脉和门静脉回到胎儿体内。静脉导管在其与下腔静脉（IVC）连接处与左侧门静脉和左侧肝静
脉相连。约有50%的脐静脉血不经肝窦直接进入IVC，其余的脐静脉血回流到肝脏，再经肝静脉进入IVC。胎儿的IVC血来自
胎儿的下半身、脐静脉及肝静脉。在下腔静脉中，来自静脉导管的血流速度比来自胎儿下半身和肝静脉的血流快，这有利于
将富含氧的血经卵圆孔（FO）运输到左心房（LA）（图1 — 1）。由于欧氏瓣（Eustachian valve）、希阿里网（Chiari network）和卵圆孔的位置关
系，下腔静脉血经右心房（RA）进入LA的时间占整个心动周期的80%。IVC血经三尖瓣进入右心室（RV）的时间占心动周
期的20%（心房收缩）。绝大部分来自上腔静脉（SVC）的血液也通过三尖瓣进入右心室。右心室射血到肺动脉（PA）。约
Shipping Overview:
• Shipping: Standard Domestic Shipping within the United States charges USD 4.99. Standard International Shipping from United Kingdom and Germany to the United States charges 14.99.
• Order Processing: Please allow 1-2 business days for order processing and preparation before shipment.
• Domestic Shipping: Orders within the U.S. are shipped via USPS or FedEx, depending on the origin of the product. The average transit time is 3-7 business days.
• International Shipping: Currently, we only ship within the USA.
• Tracking Information: Every order is trackable. You will receive a tracking number once your order has been shipped. Products may be shipped from various global fulfillment centers.
Shipping Delays:
Please note that shipping times may vary due to factors beyond our control, such as weather conditions, natural disasters, or peak holiday periods. While we strive to ensure timely delivery, the exact arrival time cannot be guaranteed and is managed by the shipping carrier.
Shipping Options:
-
Standard Delivery: Most orders are shipped within 3-7 business days. Larger items may utilize LTL shipping for safe handling.
-
Handling Time: We handle shipments on business days (Monday - Friday), with a preparation time of 1-2 days.
-
Additional Charges: Some items require additional shipping charges due to their size, weight, or special handling. These charges are specified on the product pages and are not eligible for shipping discounts.
-
Exclusions: Gift cards, packaging, taxes, and prior purchases do not count toward the minimum purchase requirement for free shipping. This offer is valid only for shipments to U.S. addresses, including Puerto Rico.
Delivery Details:
-
Estimates: Standard shipping within the US typically takes 3-7 business days. These are estimates and not guarantees.
-
Shipping Restrictions: We ship to all 50 states, Washington, DC, U.S. territories, and APO/FPO/DPO addresses. Shipping options vary based on the delivery address.
-
Remote Areas: Shipments to remote areas may incur additional charges or require pickup from a nearby shipping partner’s location.
Shipping Confirmation:
You will receive a shipping confirmation email with a tracking number as soon as your order is dispatched. If you do not receive this email immediately, please be assured that your items will arrive within the estimated delivery window provided at checkout.
Order Modifications:
If you need to cancel or modify your order, please contact our customer support immediately.
Issues with Delivery:
If your order shows as delivered but you have not received it, please contact the shipping carrier directly to resolve the issue. For persistent problems, contact our customer service at cs@everymarket.com.
Customer Support:
Our team is available 24/7 to assist you with any questions or concerns regarding your order. We are committed to ensuring a smooth shopping experience.
Return & Refund Policy Overview
Please review our return and refund policies below to ensure a smooth transaction process.
Return Policy
-
Duration: You have 30 days from receiving your item to initiate a return.
-
Condition: Items must be unworn, unwashed, with original tags and packaging intact.
-
Shipping Costs: Customers are responsible for return shipping costs.
-
Packaging: Ensure returned items are well-packaged to avoid damage during transit.
-
Tracking: Use a trackable and insured shipping method as we are not liable for items lost or damaged on return.
-
Initiating a Return: Contact us at cs@everymarket.com to start your return. We will provide a return shipping label and instructions upon approval. Returns without prior approval will not be accepted.
How to Return
-
Method: Returns must be sent back by mail to the address provided in the return instructions.
Return Label
-
Defective Products: Return labels are provided for defective items.
-
Non-Defective Returns: Customers are responsible for obtaining their return shipping label.
Product Conditions for Return
-
Eligible Products: Returns are only accepted for items in new condition.
Nonreturnable Items
Certain items are not eligible for return:
-
Electronic devices after 30 days (e.g., computers, laptops, Kindles)
-
Gift cards, prepaid game cards
-
Perishable goods, live insects, some jewelry, some health and personal care items
-
Customized or personalized products
-
Items with special shipping restrictions
Refund Policy
-
Window: Eligible products may be returned within 30 days of delivery for a refund.
-
Refund Method: Refunds are processed to the original payment method or as store credit for items purchased with gift cards.
-
Processing Time: Refunds are processed within 3-5 business days after we receive the return; please allow additional time for shipping and bank processing.
Claims
Inspect your order upon arrival and report any defects, damages, or incorrect items immediately to allow us to address the issue. For claims, contact our support team with details of the issue.
Exchange Policy
For the quickest service, return your original item and place a new order for the desired product once your return is accepted.
Return Address
EveryMarket Customer Service 2101 E Terra Ln, O'Fallon, MO 63366
Customer Support
Available 24/7 for any questions or assistance needed:
-
Phone: +1 636-312-5925
-
Email: cs@everymarket.com
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