右室双出口的外科治疗  

Surgical Treatment of double outlet right ventricle

作　　者：徐志伟[1,2] 苏肇伉[1,2] 丁文祥 

机构地区：[1]上海第二医科大学 [2]上海儿童医疗中心心胸外科

出　　处：《中华胸心血管外科杂志》1999年第6期327-329,共3页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：目的：总结手术纠治右室双出口６７ 例的经验。资料与结果：手术年龄４ 个月～１２ 岁，平均（４ ．９８ ±２ ．９６） 岁；体重４ ．１ ～３６ ．０ｋｇ，平均（１５ ．１３ ±５ ．５４）ｋｇ 。其中伴右室流出道梗阻４８ 例，肺动脉高压１８例，肺动脉瓣闭锁１ 例。１３ 例行姑息手术者无死亡。５４ 例行根治术，其中４ 例又行ＩＩ期根治，６ 例行Ｆｏｎｔａｎ 纠治术；根治手术死亡５ 例，病死率８ ．６２ ％ 。本组总病死率７ ．４６ ％ 。结论：右室双出口伴肺动脉高压者，必须早期手术，防止肺血管病变发生。对肺动脉瓣下型室缺的手术纠治较困难，死亡率高。心内隧道补片方法，术后需定期随访，及时发现左室流出道梗阻，必要时需再次手术解除。Aim:To evaluate the surgical procedure of repair of double outlet right ventricle(DORV) in 67 patients.Clinical material and method:The mean age at operation was(4.98±2.96) years (range,4 months to 12 years).The mean body weight was 15.1kg.Palliative procedures were performed in 13 patients with DORV and pulmonary stenosis including Blalock Taussig shunt in 7,Bidirectional shunt in 5 and Waterston in 1.The total repair was performed in 54 patients and Fontan procedure in 4.Results:There was no death in palliative procedure and 5 patients were died in total repair with a hospital mortality rate of 8.62%.Conclusion:The surgical treatment is important in early life for DORV with pulmonary hypertension to prevent a development of pulmonary obstructive disease.The mortality is high for DORV with subpulmonary ventricular septal defect.The patients must be followed up periodically for possible left ventricle outlet obstruction.

关 键 词：右室双出口 肺动脉高压 心脏直视手术 治疗 

分 类 号：R654.2[医药卫生—外科学] R543.205[医药卫生—临床医学]