【摘要】 目的:总结10例肺动脉瓣狭窄婴幼儿在食道超声心动图(transesophageal echocardiography,TEE)引导下,经胸小切口行肺动脉瓣球囊扩张术(简称杂交手术)的疗效。方法:2009年9月至2015年12月中南大学湘雅二医院共收治10例肺动脉瓣狭窄婴幼儿,其中男6例,女4例;年龄0.7~42(14.8±15.8)个月,其中新生儿2例;合并房间隔缺损2例,卵圆孔未闭6例,动脉导管未闭1例,肌部室间隔缺损2例,永存左上腔静脉1例,三尖瓣反流5例,均在TEE引导下接受杂交手术治疗。结果:术后所有患儿均入重症监护室继续治疗,呼吸机辅助0.5~41(6.8±12.3)h。监护室停留时间2~85(31.1±22.8)h,住院时间6~20(11.4±5.1)d。术后肺动脉跨瓣压差降至16~45(31.1±9.8)mm Hg,较术前明显降低(P<0.001)。全组无住院死亡,所有患儿术后恢复良好,顺利出院。结论:在TEE引导下行杂交手术治疗婴幼儿肺动脉瓣狭窄是一种安全、疗效优良的治疗策略。更多还原

【Abstract】 Objective:To investigate the outcomes of hybrid procedure in treating 10 infants/children with pulmonary stenosis under transesophageal echocardiographic guidance.Methods:Between September,2009 and December,2015,10 infants/children underwent hybrid procedure of transthoracic balloon pulmonary valvuloplasty for pulmonary stenosis in the Second Xiangya Hospital,Central South University.The age,height and weight at the time of admission were 0.7-42(14.8±15.8) months,53-97(74.8±16.3) cm,and 4-15.5(9.3±4.l) kg,respectively.Atrial septal defect,patent foramen ovale,patent ductus arteriosus,muscular ventricular septal defect,persistent left superior vena cava and tricuspid regurgitation were found in 2,6,1,2,1 and 5cases,respectively.Results:After the operation,all patients were sent into ICU.The mean duration mechanical ventilation,ICU stay and hospitalization were 0.5-4l(6.8±12.3) h,2-85(31.1±22.8) h,and6-20(11.4±5.1) d,respectively.Postoperative transvalvular pressure gradient reduced to 16-45(31.1±9.8) mmHg,which was decreased significantly compared with that in preoperative(P<0.001).There was no death during hospitalization and follow-up.Conclusion:Hybrid procedure of transthoracic balloon pulmonary valvuloplasty for pulmonary stenosis under transesophageal echocardiographic guidance is a safe and effective treatment.更多还原