摘要
目的总结并分析锥形心包管道重建右心室流出道的手术方法治疗Ⅲ型肺动脉闭锁／室间隔缺损患者的疗效。方法2012年1月至2014年8月，广东省心血管病研究所心外科诊治7例Ⅲ型肺动脉闭锁／室间隔缺损患儿，回顾性分析其临床资料。男3例，女4例；年龄1．4-10．8岁，中位年龄2．5岁；体质量8—17kg，平均（11．4±3．4）k。均采用锥形心包管道重建右心室流出道。结果6例同期行侧支单一化，体外循环97-174min，平均（132．7±32．5）min；主动脉阻断57～99min，平均（71．9±15．1）min。术后1例膈肌麻痹行膈肌折叠术，1例乳糜胸行胸导管结扎，1例肺部感染；使用呼吸机17．8-356．9h。无术后死亡，住ICU2．8-21．5天，总住院13-74天。随访期间患儿无死亡，无严重缺氧。结论锥形心包管道行右心室流出道重建，效果良好，术前全面评估固有肺动脉的发育情况及主肺侧支动脉，有助于术中选择合理的处理方式。
Objective To summarize the outcomes of reconstructing right ventricular outflow tract with conical pericardial conduit in type Ⅲ pulmonary atresia with ventricular septal defect （ PA/VSD ）. Methods We retrospectively analyzed the clinical data of 7 patients with type Ⅲ PA/VSD who underwent surgical repair in the Department of Cadiovascular Surgery, Guangdong Cardivascular Institute from January 2012 to August 2014. There were 3 males and 4 females at a median age of 2.5 years （ range, 1.4 to 10.8 years） and a mean weight of（ 11.4 ± 3.4 ） kg. All patients were underwent fight ventricular outflow tract reconstruction with conical perieardial conduit. Results The mean bypass time was（ 132.7 ±32.5）min, the mean aorta cross-clamping time was（71.9 ± 15.1 ） min. There was 1 patient with diaphragmatic paralysis and 1 patient with chylothorax, both of whom were underwent surgical intervention. There was 1 patient with postoperative pneumonia. The ventilation time was 17.8 - 356.9 hours. There was no in-hospital death. The mean ICU stays was 2.8 - 21.5 days and the mean hospital stays was 13 - 74 days. All patients were alive and no severe anoxia during follow-up. Conclusion The early outcomes of reconstructing right ventricular outflow tract with conical pericardial conduit in type Ⅲ PA/VSD was good. Preoperative evaluation of the pul- monary development and MAPCAs were helpful for making rational choice.
出处
《中华胸心血管外科杂志》
CSCD
2016年第8期460-463,共4页
Chinese Journal of Thoracic and Cardiovascular Surgery
基金
“十二五”国家科技支撑计划课题（2011BAI11B22）
关键词
肺动脉闭锁
右心室流出道重建
锥形心包管道
Pulmonary atresia
Right ventricular outflow tract reconstruction
Conical pcricardial conduit
