一岁以内复杂先心病双向格林手术结果分析  

Outcomes of the bidirectional Glenn procedure to treat complex congenital heart disease in infants

作　　者：史艺[1] 闫军[1] 张晶[1] 王强[1] 李巅远[1] 花中东[1] 

机构地区：[1]中国医学科学院阜外心血管病医院外科,北京100037

出　　处：《中华小儿外科杂志》2011年第2期86-88,共3页Chinese Journal of Pediatric Surgery

基　　金：基金项目：北京市科技新星项目基金资助（编号：2008112A）

摘　　要：目的总结1岁以内复杂先心病患儿行双向格林手术病例的临床特点及预后分析。方法1998年1月至2008年12月，34例单心室、肺动脉闭锁等复杂先心病畸形患儿均接受了双向格林分流手术。其中体外循环下18例，非体外循环下16例。男性21例，女性13例。平均年龄（0．66±0．21）岁，体表面积（0．16±0．05）m^2。术前经皮血氧饱和度（73±9）％，术前肺动脉压（12．19±3．68）mmHg。结果手术死亡2例，术后出现并发症5例（胸腔积液4例，乳糜胸1例）。术后肺动脉压（17．74±3．62）mmHg，经皮血氧饱和度（84±16）％。手术时间（173．55±42．16）min。结论对于1岁以内复杂先心病患儿，双向格林手术是一种简单、可靠的手术方式。对于难以解剖根治或I期Fontan手术的紫绀类肺血少复杂先心病患儿，此手术可缓解患儿的缺氧状况以及改善肺血管发育，为以后手术创造了机会。Objective To present the outcomes of bidirectional Glenn procedure to treat complex congenital heart disease in infants. Methods Between January 1998 and December 2008, 34 patients with complex cyanotic congenital heart defects underwent bidirectional Glenn operations at this center. The 38 patients, whose mean body surface area was （0. 16 ± 0. 05） m^2 , consisted of 21 males and 13 females with a mean age of （0. 66 ± 0. 21） years. Their clinical data were retrospectively ana lyzed to evaluate the clinical outcomes. Results Before surgery, mean transeutaneous oxygen saturation was （73 ± 9） %, and mean pulmonary pressure was （12. 19 ± 3.68） mmHg. On pump bidirectional Glenn procedures were performed on 16 patients, and off pump procedures on 18 patients. Mean operation time was （173.55 ± 42. 16） minutes. After operation, mean vena cava pressure was （17. 74 ± 3.62） mmHg, and mean transcutaneous oxygen saturation was （84 ± 16） %. Two patients died after surgery, and 5 patients suffered severe complications. Echocardiographic follow-up showed functioning Glenn shunts without any obstruction at the anastomosis. Conclusions Bidirectional Glenn procedure is effective to treat complex congenital heart disease in infants.

关 键 词：先天性心脏病 双向格林手术 婴儿 

分 类 号：R726.5[医药卫生—儿科]