肺动脉闭锁42例的手术结果分析  

Experiences on surgical treatment for pulmonary atresia in 42 cases

作　　者：胡曼曼[1] 范太兵[1] 李群[1] 石磊[1] 李斌[1] 

机构地区：[1]郑州大学第三附属医院,450052

出　　处：《中国实用医刊》2013年第12期34-35,共2页Chinese Journal of Practical Medicine

摘　　要：目的总结42例肺动脉闭锁患儿的外科治疗经验。方法回顾性分析2003年1月至2012年7月外科治疗42例肺动脉闭锁患儿的临床资料。其中33例伴有室间隔缺损，9例室间隔完整。42例患儿中13例行一期根治手术，29例行姑息手术，22例最终行根治手术。结果全组住院死亡9例（21．4％，9／42），2008年前6例（50％，6／12），2008年后3例（10％，3／30）；从手术方式来看，肺动脉开通术死亡1例，体肺动脉侧支形成纠治术加中央分流术死亡1例，一期根治术死亡4例，中央分流术死亡1例，室间隔完整型肺动脉闭锁根治术死亡1例，B—T分流术死亡1例。结论2008年后外科治疗肺动脉闭锁死亡比例降低，个体化姑息手术方式的选择是降低病死率的关键。Objective To summarize the surgical experiences of 42 children with pulmonary atresia. Methods The clinical data of 42 children consecutively operated from Jan. 2003 to July 2012 were retrospectively reviewed. There were 33 cases with ventricular septal defect, 9 cases with intact ventrieular septum. There were 13 cases received one-stage complete repair procedures, 29 cases received palliative operations, and 22 cases already received repair operations. Results Total post-operative inhospital mortality was 21.4% （9/42）, mortality declined from 50% （6/12） before 2008 to 10% （3/30） after 2008. From the operation method, 1 case died of pulmonary artery open surgery, 1 case died of body pulmonary collateral angioplasty with the central shunts, 4 cases died of one-stage complete repair procedures, 1 case died of the central shunts, 1 case died of intact ventrieular septum in complete repair procedures, l case died of B-T shunts. Conclusions The mortality of patients received surgical procedures are significantly decreased after 2008, and individual palliative operation mode choice is the key to reduce operative mortality.

关 键 词：肺动脉瓣闭锁 姑息手术 根治手术 

分 类 号：R726.5[医药卫生—儿科]