先天性心脏病Taussig-Bing畸形的外科治疗  

Surgical correction of Taussig-Bing anomaly

作　　者：王顺民 徐志伟[1] 刘锦纷[1] 张海波[1] 郑景浩[1] 苏肇伉[1] 丁文祥[1] 

机构地区：[1]上海交通大学医学院附属上海儿童医学中心心胸外科,上海200127

出　　处：《临床儿科杂志》2007年第10期867-869,共3页Journal of Clinical Pediatrics

基　　金：上海市科委资助项目(No.004119083;No.0-44119627)

摘　　要：目的总结一期手术治疗Taussig-Bing畸形的经验。方法2000年5月～2006年12月上海儿童医学中心手术治疗Taussig-Bing畸形43例,其中合并主动脉弓病变12例;采用大动脉换位手术(ASO)矫治Taussig-Bing畸形42例,采用Kawashima手术1例,主动脉弓病变的矫治主要是将胸主动脉与主动脉弓下缘端端吻合或与升主动脉端侧吻合。结果住院死亡8例,总死亡率18.6%。合并主动脉弓病变者并发大动脉侧侧位和冠状动脉畸形比较常见,手术死亡率(25.0%,3/12例)比单纯Taussig-Bing畸形(16.1%,5/31例)者高,但差异无统计学意义。结论Taussig-Bing畸形病理解剖比较复杂,须根据解剖条件的不同选择不同的手术方法才能降低手术死亡率。Objectives To report the experience of single stage correction of pediatric patients with Tanssig-Bing anomaly. Methods From May 2000 to December 2006, 43 patients in Shanghai Children＇s Medical Center with Tanssig- Bing anomaly underwent surgical treatments, including arterial switch operation （n = 42） and Kawashima operation （n = 1 ）. Among the 43 patients, 12 had associated aortic arch obstruction. The correction of aortic arch obstruction was performed using extended end-to-end anastomosis to aortic arch or end-to-side anastomosis to ascending aorta after resection. Results The mortality rate was 18.6% （8/43）. The incidence of side-by-side great arteries and coronary artery anomaly was more common in patients with associated aortic arch obstruction. The mortality rate was higher in patients with associated aortic arch obstruction （25.0%, 3/12） than the patients with Tanssig-Bing anomaly alone （16.1%, 5/31）. Conclusions Tanssig-Bing anomaly has complex anatomical characteristics. In order to improve the operative outcomes, optimized operative strategies should be considered according to different anomalies.

关 键 词：心脏手术 先天性心脏病 右室双出口 

分 类 号：R726.5[医药卫生—儿科]