改良Carpentier法治疗三尖瓣下移畸形32例病例分析  

The modified Carpentier's repair technique in the treatment of ebstein's anomaly:a clinical analysis of 23 cases

作　　者：张泽伟[1] 姜力骏[2] 齐建川[1] 梁凯锋 高展[1] 应力阳[1] 金杰[1] 李建华[1] 俞建根[1] 

机构地区：[1]浙江大学医学院附属儿童医院心胸外科,310003 [2]浙江大学医学院附属第一医院心外科

出　　处：《心肺血管病杂志》2013年第6期685-688,共4页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的：总结32例Ebstein畸形经改良Carpentier法手术治疗的疗效与经验.方法：回顾性分析自2003年6月至2013年8月采取改良Carpentier法手术治疗的32例Ebstein畸形（儿童23例,成人9例）的临床资料,其中男性15例,女性17例；年龄1～60岁,体质量8.5～ 68 kg.手术方式为改良Carp.ntier法,先将所有有用瓣叶切下,纵向折叠房化右心室,将瓣叶顺时针转位缝合至新瓣环根部,同期矫治合并畸形.其中6例因右心室发育差,三尖瓣瓣环小,加行双向格林术.结果：1例患儿因术后早期心律失常并发持续性低氧血症而死亡,余均存活,顺利出院.其中1例术后出现Ⅲ.房室传导阻滞,3个月后回转窦性心律.存活31例均获随访,随访时间1～72个月,其中术后复查超声心动三尖瓣反流情况轻度21例,轻中度5例,中度5例,重度1例.结论：运用改良Carpentier法手术治疗Ebstein畸形,较好保留了右心室形态,三尖瓣整形好,术后心功能恢复良好,效果满意.Objective ： To evaluate the eficacy of surgical treatment of Ebstein＇ s anomaly with modified Carpentier＇ s repair technique. Methods： From Jun. 2003 to Aug. 2013, We analyzed 32 patients （23 child and 9 adult） received corrective surgery for Ebstein＇ s anomaly with modified Carpentier＇ s repair technique ： inclu- ding 15 males and 17 females, aged from 1 year to 60 years and the weight was from 8.5 - 68 kg. On the basis of Carpentier＇ S technique, the edge of posterior leaflet was sewed to the edge of anterior leaflet or septal leaflet in favor of enlarging the area of leaflet. Associated heart lesions were corrected at the same time. 6 patients were added bidirectional Glenn operation. Results：There were one patient died of hypoxemia and arrhythmia. Com- plete heart block developed in one patient. Survivors were followed up for 1 -72months. No late death occurred. Conclusion ：In the Treatment of Ebstein＇ s Anomaly, The modified Carpentier＇ s repair technique that preserving the apex-to-base dimension of the right entricle, is feasible.

关 键 词：改良Carpentier法 EBSTEIN畸形 心脏外科手术 

分 类 号：R54[医药卫生—心血管疾病]