完全性肺静脉异位连接的解剖分型及临床意义  

Anatomic classification of total anomalous pulmonary venous connection and its clinical significance

作　　者：宋心雨[1] 李红昕[1] 邹承伟[1] 杜亮[1] 

机构地区：[1]山东大学山东省立医院心脏外科,济南250021

出　　处：《中国临床解剖学杂志》2006年第3期302-304,共3页Chinese Journal of Clinical Anatomy

摘　　要：目的:探讨完全性肺静脉异位连接(totalanomalouspulmonaryvenousconnection,TAPVC.)的解剖分型及其临床意义。方法:46例TAPVC患者按照Darling分型方法分型,并将心上型和心内型各分为2个亚形。将全组病例分成梗阻型和非梗阻型。对照术前患者的临床症状及体征及术后疗效。结果:46例TAPVC中心上型25例,肺静脉总干经垂直静脉连接于上腔静脉23例,肺静脉总干直接开口于右侧上腔静脉2例;心内型17例,肺静脉总干开口于冠状静脉窦11例,开口于右心房6例;心下型4例,肺静脉总干通过垂直静脉连接于肝门静脉。肺静脉回流梗阻7例,均依据解剖分型选择手术治疗,死亡4例,余康复出院。结论:TAPVC的解剖分型对其临床诊断及治疗有较高的价值。Objective： To explore the anatomical classification of total anomalous pulmonary venous connection （TAPVC） and its clinical significance. Methods： According to Darling method, 46 patients suffering from TAPVC were divided into different types. We also divided both supracardiac and intracardiac types into 2 subgroups. Their clinical signs were compared with their anatomical types. Results： For all cases, 25 cases were included into supracardiac type. Among them, 23 were seen that pulmonary veins drained into superior vena cava through vertical vein, 2 drained into superior vena cava directly. 17 cases belonged to the intracardiac type. Among them, pulmonary veins opened to coronary sinus in 11, directly to right atrium in 6. 4 cases belonged to infracardiac type in which pulmonary veins drained into portal vein through vertical vein. No mixed type was found. Preoperative pulmonary venous obstruction presented in 35 patients. The corrections were performed, depending on their cardiac deformation. 4 cases died. The rest of them survived with improved heart function. Conclusions： The anatomical classification of total anomalous pulmonary venous connection is valuable for their clinical diagnosis and treatment.

关 键 词：肺静脉 完全性肺静脉异位连接 解剖分型 

分 类 号：R322.11[医药卫生—人体解剖和组织胚胎学]