改良Blalock-Taussig分流术治疗复杂发绀型先天性心脏病的效果  

Effect of Modified Blalock-Taussig Shunt in Treatment of Complex Cyanotic Congenital Heart Disease

作　　者：肖海波[1] 梅举[1] 丁芳宝[1] 鲍春荣[1] 朱家全[1] 

机构地区：[1]上海交通大学医学院新华医院心胸外科,上海200092

出　　处：《实用儿科临床杂志》2011年第1期19-21,共3页Journal of Applied Clinical Pediatrics

摘　　要：目的评价改良Blalock-Taussig分流术治疗复杂发绀型先天性心脏病的效果。方法回顾性分析2006年2月-2008年12月35例在上海交通大学医学院新华医院心胸外科行改良Blalock-Taussig分流术的临床病例,术前均诊断为复杂发绀型先天性心脏病,包括肺动脉闭锁并动脉导管未闭、肺动脉闭锁并单心室、肺动脉闭锁并法洛四联症、重度法洛四联症并肺动脉发育不良及单心室并肺动脉狭窄。男19例,女16例;年龄3个月～6岁;体质量5～19kg。患儿术前均有严重的发绀症状,胸部X线摄片提示肺血流减少,术前动脉血氧饱和度为(58.7±14.1)%。手术采用直径为4～6mm的膨体聚四氟乙烯人造血管进行锁骨下动脉-肺动脉分流术。结果 35例患儿术后均获长期生存,改良Blalock-Taussig分流术后心脏超声检查提示人造血管均通畅,分流效果满意,患儿动脉血氧饱和度由术前的(58.7±14.1)%上升至(87.5±5.4)%,有显著改善(P<0.01)。术后随访6～12个月,患儿发绀症状明显减轻,活动耐量增加,未出现人造血管栓塞及其他严重并发症。结论改良Blalock-Taussig分流术风险较小,对于暂时不具备根治术条件的复杂发绀型先天性心脏病患儿,可起到挽救生命、改善缺氧、促进肺动脉发育的作用,为二期手术或根治手术创造条件。Objective To evaluate the effect of modified Blalock-Taussig shunt in treatment of complex cyanotic congenital heart di-sease（CHD）.Methods Thirty-five cases received modified Blalock-Taussig shunt in Xinhua Hospital,Medical College of Shanghai Jiaotong University from Feb.2006 to Dec.2008 were analyzed retrospectively.The diagnosis of these patients were determined as complex cya-notic CHD,including pulmonary artery atresia combined with patent ductus arteriosus,pulmonary artery atresia combined with single ventricle,pulmonary artery atresia combined with tetralogy of Fallot,severe tetralogy of Fallot combined with pulmonary artery dysplasia,single ventricle combined with pulmonary artery stenosis.There were 19 boys and 16 girls,aged 3 months-6 years,weight ranging from 5-19 kg.The symptom of these patients were severe cyanosis,pulmonary oligemia by X-ray,and the peripheral arterial blood was（58.7±14.1）% before opera-tion.Gore-Tex graft which diameter were from 4-6 mm was used to subclavian artery-pulmonary artery shunt.Results The oxygen saturation of the peripheral arterial blood significantly increased from（58.7±14.1）% in pre-operation to（87.5±5.4）% in post-operation（P0.01）.There was no postoperative death.Clinical and echocardiographic studies showed that all shunts were patent and functioned well at follow-up for 6-12 months.There was no artificial blood vessel embolism or other severe complications.Conclusions Modified Blalock-Taussig shunt may promote development of the pulmonary arteries and improve cyanosis significantly.It is a safe palliative procedure for the patients who suffer from complex cyanotic CHD modified Blalock-Taussig shunt can save the lives of the patients,and correct hypoxia to prepare for the radical operation.

关 键 词：改良BLALOCK-TAUSSIG分流术 心脏病 先天性 姑息手术 

分 类 号：R726.5[医药卫生—儿科]