心外管道全腔静脉肺动脉连接术治疗复杂先天性心脏病  

Surgical treatment of the complex congenital heart disease with the extracardiac conduct total cavopulmonary connection

作　　者：杨志远[1] 谢周良[1] 葛振伟[1] 顾以茼[1] 王佳祥[1] 程兆云[1] 

机构地区：[1]河南省人民医院心外科,郑州市450003

出　　处：《实用诊断与治疗杂志》2007年第2期108-109,112,共3页Journal of Practical Diagnosis and Therapy

摘　　要：目的：总结心外管道全腔静脉肺动脉连接术治疗复杂先天性心脏病的临床经验。方法：采用心外管道全腔静脉肺动脉连接术对12例复杂先天性心脏病患儿进行外科治疗，其中单心室7例，完全性心内膜垫缺损并右心双出口3例，右室双出口并完全性大动脉转位2例，合并三房心1例，左上腔3例，1例二尖瓣重度反流。结果：全组手术无围术期死亡，1例年龄大并二尖瓣成形者术后8d左右出现下腔静脉综合征表现，经治疗后好转；其余均无顽固性胸腹水发生。随访2～48个月，无心律失常发生，氧饱和度93％～97％，心功能（NYHA）Ⅰ～Ⅱ级。结论：心外管道全腔静脉肺动脉连接术能有效治疗不能解剖矫治的复杂先天性心脏病，弥补全腔静脉-肺动脉连接术的不足，而恰当的围术期处理是避免并发症的关键。Objective To summarize the experience of clinical application of extracardiac conduct total cavopulmonary connection in complex congenital heart disease. Methods Twelve patients with complex congenital heart disease underwent extracardiac conduct total cavopulmonary connection, including 7 cases of functional univentricle, 3 cases of complete atrioventricular septal defect with double outlet of right ventricle, 2 cases of double outlet of right ventricle with transposition of the great artery. Among them, 1 patient had cor triatriatum, 3 patients had left superior vena cave, 1 patient had severe mitral valve insufficiency. Results There was no early death or postoperative death. All patients were followed up from 2 to 48 months. All patients had no arrhythmias. The artrial oxygen saturation was from 0. 93 to 0. 97. The cardiac function was in NYHA class Ⅰ to Ⅱ. Conclusion Extracardiac conduct total cavopulmonary connection is a simple procedure. It can be used for complex congenital heart disease which can not be corrected in anatomy. Proper perioperative surgical technique is the key factor to the decrease of the serious complications.

关 键 词：先天性心脏病 心外管道 全腔静脉肺动脉连接术 

分 类 号：R654.2[医药卫生—外科学]