摘要
目的 :评价非体外循环下双向格林分流术的临床应用价值。方法 :1999年 4月～ 2 0 0 1年 4月 ,3 6例单心室等复杂先天性心脏畸形患者接受了非体外循环下的双向格林分流术(非体外循环手术组 )。包括 2 8例单侧双向格林分流术 ,8例双侧双向格林分流术。男性 2 5例 ,女性 11例。年龄 5 7±5 4岁 (6个月～ 2 4岁 ) ,体表面积 0 72± 0 3 4(0 3 5～ 1 2 8)m2 ,术前经皮血氧饱和度 0 75± 0 0 7(0 45～ 0 83 ) ,术中肺动脉压 14 3± 3 6mmHg(1mmHg =0 13 3kPa)。并以 1994～ 2 0 0 0年间在体外循环下实施双向格林分流术的 3 5例患者作为对照组 (体外循环手术组 ) ,进行比较。结果 :非体外循环手术组病例无死亡 ,1例患者出现乳糜胸。所有患者发绀明显减轻 ,顺利出院。出院时动脉血氧饱和度 0 93± 0 0 4。与体外循环手术组相比 ,在非体外循环下实施双向格林分流术可以明显减少术后呼吸机辅助时间及术后胸液引流量。结论 :非体外循环下的双向格林分流术操作较为简便 ,术后早期效果良好。
Objective:To evaluate the clinical application of bi directional Glenn shunt with off pump technique Methods:Between April 1999 and April 2001,36 patients underwent bi directional Glenn shunt without cardiopulmonary bypass,including bi directional Glenn shunt( n =28) and bilateral bi directional Glenn shunt ( n =8) The patients were 25 males and 11 females,mean age 5 7±5 4 years,range 6 month 24 years and mean body surface area 0 72±0 34 m 2,range 0 35-1 28 m 2 SpO 2 before operation was 0 75±0 07(0 45-0 83) Pulmonary pressure was 14 3±3 6 mmHg at operation This group of patients were compared with another 35 patients who underwent bi directional Glenn shunt with cardiopulmonary bypass during 1994 to 2000 in the same hospital Results:No patient died Chylothorax occurred in one patient in the early postoperative period All the other patients were discharged uneventfully The average SaO 2 was 0 93±0 04 when discharged Compared with the patients who underwent the operation with cardiopulmonary bypass,duration of respirator assistance after operation was shorter and postoperative thoracic drainage was less in those patients who underwent the operation without cardiopulmonary bypass Conclusion:Bi directional Glenn shunt with off pump technique is a useful procedure in the early management of patients with a functional univentricular heart. It is easy to perform However,much remains to be studied about this unique physiologic system
出处
《中国循环杂志》
CSCD
北大核心
2002年第3期220-222,共3页
Chinese Circulation Journal
