摘要
目的 探讨双向腔肺分流术治疗复杂先天性心脏病 (先心病 )的手术适应证、外科技巧、术后处理和疗效。方法 全组 15例病儿中男 10例 ,女 5例 ;年龄 2～ 15岁 ;体重 10～ 5 6kg。低温体外循环下手术 8例 ,其中 3例心脏不停跳 ;常温非体外循环下手术 7例 ,2例建立上腔静脉—右心房转流 ,5例利用双上腔静脉互为旁路行双侧双向腔肺吻合。结果 全组无死亡。术后随访早、中期效果满意 ,无严重并发症 ,活动量均明显改善 ,动脉血氧饱和度 (SO2 )由 0 6 5± 0 0 6上升至 0 88± 0 0 6。常温手术者不用血、呼吸机使用时间短、并发症少 ,花费低。结论 双向腔肺分流术是治疗肺血少型复杂先心病的有效术式 ,改进手术和术后处理方法可提高术后效果。常温非体外循环下手术更简便 ,创伤小 ,恢复快。
Objective: To evaluate operative indications, surgical skill, postoperative management and outcomes of bi directional cavopulmonary anastomosis in the treatment of complex congenital heart anomalies. Methods: 15 patients underwent bi directional cavopulmonary anastomosis in our hospital. There were 10 males and 5 females, age ranged from 2 to 15 years. The body weight was 10 to 56 kg. The heart anomalies included single ventricle in 9, tricuspid atresia in 4, tetralogy of Fallot with total atrio ventricular septal defect in 1 and double outlets of right ventricle in 1. 8 patients underwent the operation under the cardiopulmonary bypass and 7 patients without CPB. Results: All patients survived after surgery. During 1 to 72 months of follow up, 14 patient with preoperative cyanosis had satisfactory results. SO 2 were significant improved after operation in 14 cases [(65 2±6 4)% versus (88 2±5 7)%]. Operations without CPB were easier and recovery was smooth. Conclusion: Developing surgical skills and postoperative management was useful for improving postoperative courses of bi directional cavopulmonary anastomosis. Bi directional cavopulmonary anastomosis without CPB is easy to manipulate, with better early post operative recovery and less injury.
出处
《中华胸心血管外科杂志》
CSCD
北大核心
2002年第5期284-286,共3页
Chinese Journal of Thoracic and Cardiovascular Surgery
