【摘要】 目的:总结婴儿发绀型复杂先天性心脏病(先心病)患儿,行双向上腔静脉肺动脉吻合术病例的临床特点及预后分析。方法:2006年3月至2013年12月,36例单心室、肺动脉闭锁等复杂先心病畸形患者均接受了双向上腔静脉肺动脉吻合术。其中体外循环下8例,非体外循环下28例。男性24例,女性12例。平均年龄(0.66±0.21)岁,体表面积(0.16±0.05)m2,经皮血氧饱和度(73±9)%,术前肺动脉压(12.19±3.68)mm Hg(1mm Hg=0.133k Pa)。结果:手术死亡2例,术后出现并发症5例(胸腔积液4例,乳糜胸1例)。术后肺动脉压(17.74±3.62)mm Hg,经皮血氧饱和度(84±16)%,手术时间(173.55±42.16)分钟。结论:对于1岁以内的婴儿发绀型复杂先心病患儿,双向上腔静脉肺动脉吻合术是一种简单、可靠的手术方式。对于难以解剖根治或I期Fontan手术的发绀类肺血少复杂先心病患儿,此手术可缓解患儿的缺氧状况以及改善肺血管发育,为以后手术创造了机会。更多还原

【Abstract】 Objective: In this paper we discuss an outcome analysis of bidirectional Glenn procedure on children within 12 months with complex congenital heart disease. Methods: 36 patients with complex cyanotic congenital heart defects underwent a bidirectional Glenn shunt from March 2006 to December 2013. There were24 male and 12 female patients,the mean age was( 0. 67 ± 0. 21) years. The mean transcutaneous oxygen saturation was( 73 ± 9) % and the mean pulmonary pressure was( 12. 19 ± 3. 68) mm Hg before the operation. 28 cases were performed on-pump and 8cases were performed off-pump. Results: There were 2 patients died after operation and 5 patients suffered severe complications. Mean operation time was( 173. 55 ± 42. 16) minutes,and mean vena cava pressure was( 17. 74 ± 3. 62) mm Hg( 1mm Hg = 0. 133 k Pa),mean transcutaneous oxygen saturation was( 84 ± 16) % after operation. Follow-up echocardiography showed functioning Glenn shunts without any obstruction at the anastomosis. Conclusion: Bidirectional glenn procedure is of satisfied effect on surgical treatment for complex congenital heart disease on infant. This procedure can improve the oxygen supply and pulmonary vessel growth to whom can’t get total correction procedure.更多还原