有搏动性双向Glenn术治疗小婴儿复杂先心病的临床分析  

Application of pulsate bidirectional Glenn shunt in infants with complicated cyanotic congenital heart disease

作　　者：袁源[1] 丁芳宝[1] 鲍春荣[1] 马南[1] 沈赛娥[2] 梅举[1] 

机构地区：[1]上海交通大学医学院附属新华医院心胸外科,上海市200092 [2]上海交通大学医学院附属新华医院麻醉科,上海市200092

出　　处：《中国心血管病研究》2014年第7期604-607,共4页Chinese Journal of Cardiovascular Research

基　　金：上海市科委资助项目（项目编号：13XD1403200）

摘　　要：目的 回顾性总结3岁以内复杂先心病患儿行有搏动性双向Glenn术的治疗效果,探讨双向Glenn分流术的手术时机.方法 收集2008年1月至2013年7月间3岁内接受双向Glenn术的77例患儿资料,根据年龄分为A组（小婴儿组,＜6个月,23例）和B组（婴幼儿组,6-36个月,54例）,比较两组患儿围手术期及术后随访资料.结果 A、B两组患儿的手术时间[（148.20±21.21）min、（154.87±52.37）min]、呼吸机辅助时间[（30.63±23.86）h、（24.61±18.83）h]、ICU滞留时间[（6.35±4.16）d、（4.90±2.57）d]、术后住院时间[（12.11±3.68）d、（10.03±4.82）d]、血制品使用量[（401.21±276.79）ml、（435.76±226.95）ml]及术后引流量[（15.68±7.32）ml/kg、（17.78±8.43）ml/kg]比较差异均无统计学意义（P＞0.05）.术后两组患儿肺动脉均较术前明显发育（P＜0.05）,两组间发育程度比较差异无统计学意义（P＞0.05）.18例患儿（A组6例,B组12例）后期接受了TCPC治疗.结论 对于无法行一期根治的复杂发绀型先心病患儿,即使是＜6个月的小婴儿,有搏动性双向Glenn术都是安全、有效的治疗方法.Objective To review the effect of pulsatile bidirectional Glenn （BDG） shunt in infants,and estimate the optimal time for this procedure.Methods 77 patients under the age of three underwent a pulsatile BDG shunt between January 2008 to July 2013.According to the age,they were divided into Group A（＜6 months old,n=23） and Group B（6 to 36 months old,n=54）.Retrospective statistical analysis was carried on the in-patient data and follow-up outcomes.Results No statistically significant difference was found between the two group on operation time [（148.20±21.21）min,（154.87±52.37）min],ventilation time [（30.63±23.86）h,（24.61±18.83）h],ICU stay time [（6.35±4.16）days,（4.90±2.57）days],postoperative hospitalization [（12.11 ±3.68）days,（10.03± 4.82）days],the use of blood [（401.21±276.79）ml,（435.76±226.95）ml] and postoperative drain [（15.68± 7.32）ml/kg,（17.78±8.43）ml/kg] （P＞0.05）.Pulmonary arteries were significantly developed in all of the patients,but there was no statistical analysis difference on the growth rate between the two groups （P＞0.05）.18 patients（6 from Group A,12 from Group B） underwent TCPC procedure after then.Conclusion The pulsatile BDG shunt can be applied to children with complicated cyanotic congenital heart disease including several months-old infants.

关 键 词：先天性心脏病 心脏手术 双向格林分流术 

分 类 号：R654.2[医药卫生—外科学]