三尖瓣环切开技术在膜周部室间隔缺损修补术中的应用  

Temporary tricuspid valve detachment applied in surgical closure of congenital Perimembranous ventricular septal defect

作　　者：高荣[1] 李仲智[1] 李晓峰[1] 袁峰[1] 张玉龙[1] 

机构地区：[1]首都医科大学附属北京儿童医院心脏中心,北京市100045

出　　处：《中国心血管病研究》2005年第4期258-259,共2页Chinese Journal of Cardiovascular Research

摘　　要：目的三尖瓣环切开(TVD)技术在膜周部室间隔缺损(VSD)修补术中的应用。方法总结1996年1月～2000年12月室间隔缺损修补术后患儿525例,应用三尖瓣环切开技术96例。结果TVD组比非TVD组年龄小、体重低,但术前合并其他畸形,术中主动脉阻断时间、体外循环时间、直接缝合率,以及术后死亡率两组之间没有显著差异。术后TVD组发生少量三尖瓣反流(TI)32例,非TVD组发生少量TI141例。术后TVD组发生小量残余分流(RS)22例,非TVD组发生小量RS93例,TI和RS两组之间差异无统计学意义(P>0.05)。对两组中56例患儿进行随访3年,其中31例患儿RS自动闭合。结论TVD可以提高膜周部VSD的显露且手术并发症很低,不会增加TI、RS发生率。Objective The purpose of this study is to evaluate temporary tricuspid valve detachment (TVD) applied in surgical closure of congenital Perimembranous ventricular septal defect(VSD). Methods Between January 1996 and December 2000 a series of 525 patients were operated for closure of VSD. TVD was applied in 96 patients (18.3%) to enhance exposure of the defect using transatrial approach. Results Parameters showed that TVD group was young and a lower weight than non-TVD group. But there was no significant difference in cross-clamp time and CPB time between both groups. Trivial tricuspid valve insufficiency(TI)was detected 32 in TVD group and 141 in non-TVD group after operation. Postoperative echocardiography detected that 22 patients had trivial residual shunting (RS) in TVD group, 93 patients had trivial RS in non-TVD group. During follow-up in 56 patients the trivial RS closed spontaneously in 31 patients at a median time of 3 years. Conclusion TVD is a safe method to enhance the exposure of perimembranous VSD. TVD does not increase postoperative complications, particular TI and RS.

关 键 词：三尖瓣环切开技术 外科 膜周部室间隔缺损 先天性心脏病 

分 类 号：R654.2[医药卫生—外科学]