摘要
目的回顾总结一期纠治婴幼儿先天性心脏病(先心病)伴气管狭窄的体会。方法 2001年8月至2005年11月,6例先心病伴气管狭窄的婴幼儿行一期手术矫治。手术年龄24 d～3岁;体重4.2～10.0kg,平均(7.98±2.03)kg。其中法洛四联症3例,1例伴肺动脉闭锁;室间隔缺损2例,1例伴主动脉缩窄;肺动脉吊带1例。所有病儿均在低温体外循环下行先心病纠治术,同时处理气管狭窄。结果术后早期1例左、右支气管均匀性狭窄,不能脱离呼吸机死亡。1例肺动脉吊带者术后顺利出院,3个月后出现气管内肉芽增生,家属放弃治疗。余4例术后恢复良好,随访6个月至4年,临床上无气促表现。超声复查心功能良好,其中3例经 CT 复查,显示气管吻合口通畅,无明显狭窄。结论先心病伴先天性气管狭窄,以一期手术治疗为好,不但术中在体外循环下纠治气管狭窄较安全,而且同时纠治先心病有利于手术后病儿康复。
Objective To review and evaluate the effect of one stage surgical correction of congenital heart disease with tracheal stenosis in infants, nethocls Between August 2001 and December 2005, six infants with congenital heart disease with tracheal stenosis were repaired at one stage operation. The age was 24 d - 3 y [ mean （ 13.16 ± 12.03 ） months] and the weight was 4.2 - 10.0 kg [mean （7.98 ± 2.03） kg]. There were 3 patients with tetralogy of FaUot, 1 with pulmonary atresia; 2 with ventricular septal defect, 1 with coarctafion of aorta; and 1 with pulmonary sling. The congenital heart disease were repaired underwent low temperature and car- diopulmonary bypass, and the tracheal stenosis were corrected simultaneously. Results There was one death postoperative because of fight and left bronch stenosis. One patient with pulmonary sling died of granulation tissue on the patch 3 months after operation. All other 4 patients recovered uneventfully. These patients were followed up from 6 month to 4 years. There were no complications. CT scan shows that the tracheal anastomosis was patent without any stenosis. Conclusion One stage repair of congenital heart disease with tracheal slenosis in infants may have a satisfactory resuit. To deal with the tracheal stenosis is difficult, the operative methods depends on the length of stenosis. The principles of surgical methods consist of using autologous material, maintaining its contour and function of respiratory epithelium, and maintaining its growth.
出处
《中华胸心血管外科杂志》
CSCD
北大核心
2007年第4期217-219,共3页
Chinese Journal of Thoracic and Cardiovascular Surgery
关键词
心脏缺损
先天性
气管狭窄
/外科学
Heart disease, congenital Tracheal stenosis /surgery
