非体外循环下全腔静脉-肺动脉连接术治疗复杂先天性心脏病16例分析  

Surgical treatment of the complex congenital heart disease with the total cavopulmonary connection without cardiopulmonary bypass:a report of 16 patients

作　　者：刘瑞生[1] 宋兵[1] 柳德斌[1] 唐汉博[1] 程殿威[1] 

机构地区：[1]兰州大学第一医院心血管外科,730000

出　　处：《中国现代医药杂志》2011年第10期37-38,共2页Modern Medicine Journal of China

摘　　要：目的总结非体外循环下全腔静脉-肺动脉连接术(TCPC)治疗复杂先天性心脏病的临床经验。方法回顾性分析我院2006～2010年接受TCPC的16例复杂先天性心脏畸形患者,包括三尖瓣闭锁9例(其中1例为双向Glenn术后5年),完全性大动脉转位合并房室间隔缺损、肺动脉瓣狭窄4例,右室双出口伴其他畸形2例,单心室1例,均采用非体外循环下手术。结果术后无1例死亡,均痊愈出院,3例术后出现大量胸腔积液,经积极处理后恢复。所有患者症状消失,无明显发绀,经皮血氧饱和度达到89%～97%,恢复良好。结论 TCPC方法简便易行,在严格掌握手术适应证、手术技巧及加强术后并发症防治的情况下,TCPC治疗复杂型先天性心脏病可取得良好的手术效果。Objective To summarize the experience of clinical application of total cavopulmonary connection without cardiopulmonary bypass in complex congenital heart disease. Methods Retrospectively analyzed 16 patients with complex congenital heart disease underwent total cavopulmonary connection from 2006 to 2010,including 9 cases of tricuspid atresia （one of them was received bidirectional Gleen procedure 5 years ago）, 4 cases of complete transposition of great artery with atrioventricular septal defect and pulmonary valve stenosis,2 cases of double outlet of right ventricle,and 1 case of univentricle.All patients underwent off-pump TCPC. Results There was no early death or postoperative death. 3 patients have hydrothorax after operation.The transcutaneous oxygen saturation was from 0.89 to 0.97. Conclusion TCPC is a simple procedure.h can be used for complex congenital heart disease which can not be corrected in anatomy. It has good results by choosing adequate indication before operation, designing procedures during operation and treating complications after operation.

关 键 词：全腔静脉-肺动脉连接术 非体外循环 复杂先天性心脏病 

分 类 号：R654.2[医药卫生—外科学]