常温非体外循环下单纯肺动脉瓣狭窄交界切开术177例  

Surgical valvulotomy for isolated valvular pulmonary stenosis in normothermia without cardiopulmonary bypass:report of 177 cases

作　　者：安君[1] 阎德民[2] 谷春久[2] 

机构地区：[1]吉林大学附属第一医院心脏外科,长春市130021 [2]中国医科大学附属第一医院心脏外科

出　　处：《中国心血管病研究》2007年第6期406-407,共2页Chinese Journal of Cardiovascular Research

摘　　要：目的总结常温非体外循环下肺动脉瓣狭窄交界切开术的经验。方法对177例单纯肺动脉瓣狭窄患者实行了常温非体外循环下肺动脉瓣狭窄交界切开术。结果全组手术顺利,无手术死亡。术后无低心排综合征、呼吸功能不全等并发症发生。术后杂音完全消失8例,余均残留2-4/6收缩期杂音。术后随访表明,术后跨瓣压差均在30mmHg以下,无或仅有轻度肺动脉瓣关闭不全,患者心功能得到明显改善,均恢复正常生活、工作。结论常温非体外循环下肺动脉瓣狭窄交界切开术是安全、可靠的术式,对确诊为单纯肺动脉瓣狭窄且无重度右室流出道狭窄,尤其经济条件差无法承受较高治疗费用的病例而言,仍是可以选择的术式。Objective To assess experiences of surgical treatment on isolated valvular pulmonary stenosis. Methods 177 patients of isolated valvular pulmonary stenosis who have undergone surgical valvulotomy in normothermia without cardiopulmonary bypass （CPB） were analyzed. Results Pulmonary valvulotomy was performed in 177 patients （84 females, 93 males; mean age 15.88~1.19 years; range： 1.3-40.0 years） with isolated valvular pulmonary stenosis. There were no immediate or late deaths without postoperative major complications. Follow-up （mean period 13.75±9.01 month; range： 6-48 months） indicate that infundibular gradients in all patients were less than 30 mm Hg without pulmonary regurgitation or with mild pulmonary regurgitation. Conclusion Although balloon valvuloplasty for pulmonary valve stenosis is trend in nowadays, surgical valvulotomy in normothermia without CPB is still effective and safe, and represents a good alternative to isolated valvular pulmonary stenosis.

关 键 词：肺动脉瓣下狭窄 心脏外科手术 体外循环 气囊扩张 

分 类 号：R654.2[医药卫生—外科学]