摘要
背景:行法洛四联症矫治手术时,对右室流出道狭窄较严重的病例,常需要行右室流出道补片加宽成形,目前采用的加宽材料有生物补片及人造织物补片等。目的:比较涤纶人造血管片和组织工程牛心包补片在法洛四联症分期矫治手术中加宽右室流出道的早期临床效果。方法:25例已行一期分流手术后再行二期心内矫治的法洛四联症患者,按照不同的二期手术时间分为两组:2007年4月至2010年7月接受二期手术的14例患者以涤纶人造血管片加宽右室流出道;2010年8月至2011年9月接受二期手术的11例患者,采用商品化的组织工程牛心包补片加宽右室流出道。比较两组术后早期的临床效果。结果与结论:25例患者中,仅涤纶人造血管片组术后死亡1例,术后开胸止血1例,所有均未出现免疫排斥反应和毒性反应。组织工程牛心包补片组术后呼吸机使用时间、体外循环稳定后测量的右心室与左心室收缩压比值、右心室流出道压差、心包腔引流量、术后ICU治疗时间和术后住院天数均少于涤纶人造血管片组(P<0.05)。说明采用组织工程牛心包补片加宽右室流出道的患者术后恢复较采用涤纶人造血管片的患者快,右室流出道疏通效果好,提示组织工程牛心包补片是法洛四联症患者分期矫治手术中加宽右室流出道的一种较理想材料。
BACKGROUND： A perfect repairing material is necessary to improve the quality of life in staged repair of Tetralogy of Fal ot to enlarge the right ventricular outflow tract that is serious narrow. The materials currently used for outflow tract widening include biological patch and man-made fabric patch. OBJECTIVE： To compare the effects of tissue-engineered bovine pericardium patch and Dacron patch in staged repair of Tetralogy of Fal ot to widen the right ventricular outflow tract. METHODS： Twenty-five patients with Tetralogy of Fal ot who had undergone the first-stage shunt operation were divided into two groups according to the date of second stage surgery. Polyester-made artificial blood vessel patch group included 14 cases, and the right ventricular outflow tract was enlarged with polyester-made artificial blood vessel patches （from April 2007 to July 2010）; tissue engineered bovine pericardium patch group included 11 cases, and the right ventricular outflow tract was enlarged with bovine pericardium patches （from August 2010 to September 2011）. Clinical effects of the two groups in the early stage postoperation were compared. RESULTS AND CONCLUSION： There was one case of postoperative death in the polyester-made artificial blood vessel patch group. Ventilator time, the ratio of right ventricular pressure and left ventricular pressure, the pressure gradient across the right ventricular outflow tract, the pericardial cavity drainage volume, ICU time and length of hospital stay in the bovine pericardium patch group were less than those in the polyester-made artificial blood vessel patch group （P 〈 0. 05） . Tissue engineered bovine pericardium patch can be adapted as a better repairing material in staged repair of Tetralogy of Fal ot to enlarge the right ventricular outflow tract.
出处
《中国组织工程研究》
CAS
CSCD
2013年第12期2197-2204,共8页
Chinese Journal of Tissue Engineering Research
关键词
生物材料
生物材料临床实践
法洛四联症
组织工程牛心包
右室流出道
涤纶人造血管片
二期心内矫治
并发症
biomaterials
biomaterial clinical practice
Tetralogy of Fallot
tissue-engineered bovine pericardium
right ventricular outflow tract
polyester-made artificial blood vessel patch
second-stage intracardiac correction
complications
