摘要
目的总结1998年4月至2005年12月行双向 Glenn 手术治疗68例儿童功能性单心室的经验。方法本组男47例,女21例;年龄5个月～14岁(中位年龄3.7岁);体重6.7～30.0 kg(中位体重12.5 kg)。右侧双向 Glenn 手术39例,左侧双向 Glenn 手术13例,双侧者16例。同期行肺动脉环束3例、肺动脉结扎1例、主动脉-肺动脉分流管道切断缝合术1例、动脉导管结扎6例、大侧支循环切断4例、全肺静脉异位引流矫治1例、部分肺静脉异位引流矫治2例、房室瓣整形4例。结果 68例患者死亡3例,病死率4.4%。术后上腔静脉压力(15.9±2.4)mm Hg(1 mm Hg=0.133kPa),较术前的(8.3±1.8)mm Hg 显著上升(P<0.01)。术后安静时经皮血氧饱和度(89.3±4.2)%,较术前的(78.4±6.0)%显著上升(P<0.01)。结论双向 Glenn 手术治疗功能性单心室效果满意;双向 Glenn 手术宜保留肺动脉的搏动性血流。
Objective To analyze 68 pediatric cases with functional univentricle heart who underwent bidirectional Glenn procedure during from April 1998 to December 2005. Methods There were 47 males and 21 females in this group, aged from 5 months to 14 years old and weighed from 6. 7 to 30.0 kg. Among them, 39 cases were received bidirectional Glenn procedure on the right side, 13 cases on the left side and 16 cases on both sides. Three cases had the pulmonary artery banded; one case had the pulmonary artery ligated;one case had the original A-P shunt cut off; six cases had the PDA ligated; four eases had the MAPCAs cut off; one case had TAPVC corrected eontemporarily; two cases of PAPVC were alse corrected; four eases had the atrial-ventrieular valve repaired. Results Three eases died. The mortality was 4. 4%. The mean post-operative pressure of super vena eava was （ 15.9 ± 2.4） mm Hg （ 1 mm Hg = 0. 133 kPa） , higher than the pre-operative one （8.3 ± 1.8） mm Hg（P 〈0. 01 ）. The mean post operative SpO2 was （ 89. 3 ±4.2） % , higher than the pre-operative one （ 78. 4 ±6.0 ） % （ P 〈 0. 01 ）. Conclusions Bidirectional Glenn procedure is of satisfied effect on surgical treatment for functional univentriele heart. The persistent forward flow from pulmonary artery shoule be reserved in bidirectional Glenn procedure.
出处
《中华外科杂志》
CAS
CSCD
北大核心
2007年第12期812-814,共3页
Chinese Journal of Surgery
关键词
三尖瓣闭锁
双向GLENN手术
功能性单心室
儿童
Tricuspid atresia
Bidirectional Glenn procedure
Functional univentriele heart
Child
