非体外循环双向Glenn术在小儿复杂先天性心脏病治疗中的临床作用研究  

Clinical application of bidirectional Glenn shunt without extracorporeal circulation for complicatedcongenital heart disease in children

作　　者：陈国庆[1] 孙婷[2] 乔衍礼[1] 倪良春[1] 郑善光[1] 王为新[1] 

机构地区：[1]济宁医学院附属医院心脏外科,山东济宁272129 [2]山东省济宁市第二人民医院重症监护室

出　　处：《中国医师进修杂志》2012年第24期17-19,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨非体外循环双向Glenn术治疗小儿复杂先天性心脏病的临床应用效果。方法选取采用非体外循环双向Glenn术治疗复杂先天性心脏病患儿46例（非体外循环组），同期采用体外循环双向Glenn术治疗复杂先天性心脏病患儿40例（体外循环组），比较两组的临床疗效。结果两组均无死亡病例。非体外循环组术后肺动脉压显著低于体外循环组[（16．7±1．2）mmHg（1mmHg=0．133kPa）比（18．9±1．0）mmHg]，差异有统计学意义（t=4．686，P=0．026）；非体外循环组术后呼吸机辅助呼吸时间显著短于体外循环组[（12．2±2．7）h比（19．2±2．8）h]，差异有统计学意义（t=2．972，P=0．041）；两组术后血氧饱和度、乳糜胸发生率比较差异无统计学意义（P〉0．05）。所有患儿术后紫绀、活动后气促等症状、体征明显减轻。结论非体外循环双向Glenn术疗效显著、安全可靠，是治疗复杂先天性心脏病有效的手术方法。Objective To evaluate the clinical application of bidirectional Glenn shunt without extracorporeal circulation （ECC） on treatment of children with complicated congenital heart disease （CHD）. Methods Forty-six patients with complicated CHD （without ECC group） underwent bidirectional Glenn shunt without ECC, and 40 patients with complicated CHD （with ECC group） underwent bidirectional Glenn shunt with ECC. The therapeutic effect was compared between two groups. Results There was no operative mortality in two groups. The pulmonary artery pressure in without ECC group was significantly lower than that in with ECC group [ （ 16.7 ± 1.2） mm Hg （1 mm Hg = 0.133 kPa） vs. （ 18.9 ± 1.0） mm Hg,t = 4.686,P = 0.026 ]. Duration of respirator assistance after operation in without ECC group was significantly lower than that in with ECC group [ （ 12.2 ± 2.7） h vs. （ 19.2 ± 2.8） h, t = 2.972, P = 0.041 ]. There was no significant difference in saturation of blood oxygen and the rate of chylothorax after operation between two groups （P 〉 0.05）. The symptoms and signs including cyanosis and breath were markedly alleviative in all patients. Conclusion Bidirectional Glenn shunt without ECC is an effective and safe method for complicated CHD.

关 键 词：心脏缺损 先天性 儿童 双向GLENN术 

分 类 号：R726[医药卫生—儿科]