摘要
目的总结婴幼儿主动脉缩窄伴室间隔缺损胸骨正中切口Ⅰ期纠治的手术方法和临床经验。方法2000年1月-2004年5月，采用胸骨正中切口Ⅰ期纠治17例主动脉缩窄伴室间隔缺损患儿，月龄1～41个月；体重3．0～13kg，平均为（6．32±2．35）kg。主动脉缩窄位于导管前11例，邻近动脉导管处6例；其中4例伴主动脉弓发育不良。9例伴有动脉导管未闭．17例均伴有室间隔缺损。结果本组17例中，1例于矫治术后第2d死于肺动脉高压危象；余16例术后恢复良好，其中14例上下肢动脉压差消失，另2例上下肢动脉压差24h内降至15mmHg（1mmHg=0．133kPa），72h后压差消失。随访至今超声心动图检查无假性动脉瘤或主动脉再狭窄。结论采用胸骨正中切口Ⅰ期纠治主动脉缩窄伴室间隔缺损，可同时纠治并发的主动脉弓部发育不良，降低了残余梗阻的发生率。Ⅰ期矫治还具有明显降低手术费用，减少患儿二次手术痛苦的优点。Ⅰ期手术在死亡率和并发症方面与Ⅱ期手术没有显著性差异。
Objective To review the one-stage surgical repair of aortic coarctation （Coa） with ventricular septal defect （VSD） in infants by median sternotomy. Methods From January 2000 to May 2004, 17 patients with Coa and VSD underwent one-stage repair in this institute. The age ranged from 1 to 41 months, and the body weight ranged from 3. 0 kg to 13 kg （mean 6. 32 kg）. There were 11 patients with preductal and another 6 cases with iuxtaductal Coa. In which, 4 cases were accompanied by diffuse hypoplasia of aortic arch. These patients were also complicated with other congenital heart diseases such as PDA in 9 and VSD in 17. Results All patients were survival except one patient died of crisis of. pulmonary hypertension after surgery. The difference of systolic blood pressure between upper and lower limb was restored in all survival infants. There was no complication in these patients during follow up. Conclusions Infantile Coa with VSD can be repaired in one-stage by median sternotomy This operative approach is beneficial, not only with less operative cost, but also with simultaneous correction of hypoplasia of aortic arch to decrease the residual obstruction.
出处
《中华小儿外科杂志》
CSCD
北大核心
2006年第1期20-22,共3页
Chinese Journal of Pediatric Surgery
基金
浙江省教育厅科研项目资助(491040-G20263)
关键词
主动脉缩窄
室间隔缺损
Aortic coarctation
Heart septal defects,ventricular
