右室双出口45例外科治疗体会  

Experiences of surgical treatment in 45 cases with double outlet of right ventricle

作　　者：石践[1] 邵展社[1] 邵继凤[1] 李学文[1] 康云帆[1] 郭建军[1] 王宗超[1] 宋保国[1] 

机构地区：[1]陕西省人民医院心脏外科,西安710068

出　　处：《陕西医学杂志》2009年第6期680-682,共3页Shaanxi Medical Journal

摘　　要：目的:探讨右室双出口矫治的外科治疗经验。方法:45例右室双出口患者,其中室间隔缺损位于主动脉瓣下33例,肺动脉瓣下8例,两大动脉下2例,远离两大动脉2例。其中行根治术43例,全腔静脉-肺动脉连接术1例,肺动脉环缩术1例。结果:术后早期4例病人死亡,余41例均恢复良好,超声心动图示心室流出道通畅,无残余分流。结论:右室双出口解剖类型复杂多样,根据不同的解剖类型,选择最佳的手术方式和手术时机,保证重建的左右心室流出道通畅,是手术成功的关键。合理的围术期治疗是保证疗效的必要措施。Objective： To summarize the experiences and results of surgical treatment for double outlet of right ventricle in 45 cases. Methods ：From April 2005 to April 2008,45 cases with double outlet of the right ventricle, age from 2 months to 32 years, underwent surgical procedure. There were 33 subaortic ventricular septal defect, 8 subpulmonary ventricular septal defect, 2 doubly committed ventricular septal defect, 2 non-committed ventrieular septal defect. Forty-three Patients underwent surgical repair procedure,1 received total cavo-pulmonary connection procedure, 1 pulmonary banding procedure. Results：Four cases died in the early postoperative period, with a mortality of 8. 9%. Other forty-onepatients discharged asymptomatically. The outcome was satisfactory. Conclusion： The anatomic type, especially the position of ventricular septal defect and development of left ventricle, correlates with surgical strategy significantly. Low cardiac output syndrome contributes to the major risk factor postoperatively. Effective prophylaxis and control of low cardiac output syndrome is a useful strategy.

关 键 词：右室双出口 外科学 外科治疗 先天性心脏畸形 

分 类 号：R654.2[医药卫生—外科学] R541.1[医药卫生—临床医学]