小儿先天性主动脉瓣病变的个体化治疗  

The individualized treatment for children with congenital aortic valve disease

作　　者：朱贵军[1] 严哲[1] 陈兴澎[1] 王亚宏[1] 蔡巍巍[1] 李斌[1] 李晓恒[1] 张小涛[1] 赵勇鹏[1] 

机构地区：[1]郑州大学附属洛阳中心医院心外科,河南省洛阳市471009

出　　处：《中国心血管病研究》2016年第2期167-169,共3页Chinese Journal of Cardiovascular Research

摘　　要：目的探讨小儿先天性主动脉瓣病变的外科治疗疗效及个体化治疗方案的临床价值。方法2008年9月至2015年7月期间个体化治疗的17例先天性主动脉瓣病变的患儿，男性11例，女性6例，年龄2个月至16岁，体重3．1-51．0（15．6±5．2）kg；年龄分布：〈1岁2例；1-3岁2例，3-16岁13例。手术在全麻、低温、体外循环下进行，结合超声、CT及术中情况，手术方案实现个体化。结果行主动脉瓣机械瓣置换手术（AVR）3例，应用带瓣人造血管替代升主动脉根部及主动脉瓣并移植冠状动脉的手术（Bentall术）1例，行Ross手术2例，行改良Ross手术6例，行主动脉瓣成形手术（AVP）5例。全组无手术死亡，随访中未发现明显的瓣膜返流，患儿正常生活不受影响。结论zbJL先天性主动脉瓣病变的个体化治疗对于外科治疗有更好的临床指导意义。中远期主动脉瓣再次发生病变是影响预后的重要因素，值得进一步研究关注。Objective To explore the curative effect of surgical treatment of children with congenital aortic valve lesions and clinical value of individualized treatment plan. Methods Between September 2008 and July 2015, 17 eases of children with congenital aortic valve disease were accepted individual treatment. Male in 11 cases, female 6 cases, years of age from 2 months to 16 years old; weight 3.1-51.0 （15.6±5.2）kg; age distribution were：〈1 year old 2 cases, 1-3 years old in 2 eases, 3-16 years old in 13 cases. Surgery under general anesthesia, low temperature, extracorporeal circulation, in combination with ultrasound, CT and intraoperative situation. All patients accepted individualized operation schemes. Results The operation Row aortic valve and mechanical valve replacement （AVR） in 3 case, BentaU surgery in 1 case, Ross procedure in 2 cases, improved Ross procedure in 6 cases, aortic valve forming operation （AVP） in 5 cases. Conclusion The individualized surgical treatment provides a better clinical significance for children with congenital aortic lesions, and long-term aortic valve lesions occur again is the important factors that affect prognosis, deserves further research.

关 键 词：先天性心脏病 主动脉瓣瓣病变 外科治疗 个体化治疗 儿童 

分 类 号：R654.2[医药卫生—外科学]