摘要
目的：总结Ⅲ型肺动脉闭锁／室间隔缺损的外科疗效。方法回顾性分析2005年9月至2014年12月广东省心血管病研究所心外科诊治的98例Ⅲ型肺动脉闭锁／室间隔缺损患儿（者）的临床资料。男54例，女44例；年龄14天～23.3岁，平均（4.2±4.8）岁；体质量2～67 kg，平均（13.2±10.0） kg。67例行姑息性手术，31例行根治性手术；体外循环下手术85例。结果体外循环48～284 min，平均（121.2±49.4） min，其中9例姑息手术在心脏不停搏下完成，76例主动脉阻断9～204 min，平均（75.4±31.8） min。术后死亡6例（6.1％）。生存患者呼吸机辅助3.8～1184.0 h，平均（106.7±184.3） h；住ICU 0.8～65.8天，平均（8.9±10.9）天；总住院10～118天，平均（33.4±17.0）天。姑息手术组与根治手术组术后结果差异无统计学意义。随访期间，28例再次手术，死亡2例（7.1％，2／28），余者生活状态良好。结论Ⅲ型肺动脉闭锁／室间隔缺损的外科治疗效果良好，术前全面评估固有肺动脉的发育情况及侧支血管，有助于选择合理的手术方式，术后随访期间对有指征的患者应积极再次手术。
Objective To evaluate the outcomes of surgical repair of typeⅢ pulmonary atresia with ventricular septal de-fect（ PA/VSD） .Methods Retrospectively analyzed the clinical data of 98 patients with type Ⅲ PA/VSD who underwent sur-gical repair in the Department of Cardiovascular Surgery , Guangdong Cardiovascular Institute from September 2005 to December 2014.There were 54 males and 44 females at the mean age of（4.2 ±4.8） years and the mean weight of（13.2 ±10.0） kg. There were 67 patients in palliative repair group and 31 patients in radical repair group .There were 85 patients underwent on-pump operation including 9 beating heart cases.Results The mean bypass time was（121.2 ±49.4）min, the mean aorta cross-clamping time was（75.4 ±31.8） min.The overall postoperative mortality was 6.1%（6/98）.For the survival patients, the mean ventilation time was（106.7 ±184.3） h, the mean ICU stay was（8.9 ±10.9） days and the mean hospital stay was （33.4 ±17.0）days.During follow-up period, 28 patients were underwent re-operation, the postoperative mortality was 7.1%（2/28）.There were no differences in postoperative status between two groups.Conclusion The outcomes of surgical repair for type Ⅲ PA/VSD was good.Preoperative evaluation of the pulmonary development and MAPCAs were helpful for choosing surgical options.Re-operation was recommended to those appropriate patients.
出处
《中华胸心血管外科杂志》
CSCD
2017年第1期1-4,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
肺动脉发育
手术方式
Pulmonary atresia
Pulmonary artery development
Surgical options
