成人先天性心脏病外科手术疗效分析  

Surgical Treatment of Adult Congenital Heart Disease

作　　者：张荣媛[1] 张燕搏[1] 杨克明[2] 黄海波[1] 史晨[1] 蒙沿海 常硕[1] 杨秋蓝[1] 刘子娜[1] 刘玲峰[1] 

机构地区：[1]中国医学科学院北京协和医学院心血管病研究所阜外医院心外科重症监护室,北京100045 [2]中国医学科学院北京协和医学院心外科,北京100045

出　　处：《中国胸心血管外科临床杂志》2016年第6期573-576,共4页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：国家自然科学基金(81400305);北京市自然科学基金(7142137);中央级公益性科研院所基金(2013-F19);协和青年科研基金(3320-15104)~~

摘　　要：目的探讨成人先天性心脏病（adult congenital heart disease,ACHD）的临床特点及外科手术治疗效果。方法回顾性分析阜外医院2012年1月至2015年6月502例手术治疗的成人先天性心脏病患者的临床资料,其中男205例、女297例,年龄18-65（34.01±11.97）岁,体重19-96（58.60±12.60）kg。结果房间隔缺损（ASD）占43.8%,室间隔缺损（VSD）占26.6%,法洛四联症（TOF）占5.4%。年龄18-65岁,65.13%的患者在40岁前接受手术,以20-29岁年龄组人数为最多,其次分别是40-49岁年龄组,再次是30~39岁年龄组。共完成根治术471例,手术早期成功率99.57%。姑息手术29例,手术早期成功率96.55%;二次手术2例,手术早期成功率100.00%。患者术后呼吸机平均辅助时间19.03 h;ICU治疗平均时间2.22 d。术后共51例患者发生术后并发症,发生率10.15%。结论 ACHD手术适应证及术式选择很重要,手术操作有一定难度和技巧,围术期处理也是手术成功的关键。Objective To investigate the results of the surgical treatment of adult congenital heart disease（ACHD）. Methods We retrospectively analyzed the clinical data of 502 patients with ACHD underwent operation treatment in Fu Wai Hospital between January 2012 and June 2015. There were 205 males and 297 females at age of 18-65（34.01±11.97） years and weight of 19-96（58.60±12.60） kg. Results Atrial septal defect had the highest incidence of ACHD,the proportion accounted for 43.8%.The followed was ventricular sepal defect,accounting for 26.6%. And the third is tetralogy of Fallot,accounting for 5.4%. The age ranged from 18 to 65 years. A percentage of 65.13% patients received operation when they are younger than 40 years,with the most patients at age of 20-29 years,the least patients at age of 30-39 years. We completed a total of 471 patients of early orthodontic treatment with operation success rate at 99.57%. We completed 29 patients palliative operation with early operation success rate at 96.55%. And there were 2 patients with re-operation at success rate of 100.00%. The postoperative patients with ventilator assisted time was 19.03 h. The mechanical ventilation time was 19.03 h. ICU treatment time was 2.22 d. Postoperative complications occurred in 51 patients with incidence rate at 10.15%. Conclusion It is very important to impose proper surgical method on different patients. The operation doctor should be trained skillfully. Perioperative management is also a key stage to the success of the operation.

关 键 词：先天性心脏病 手术 成人 

分 类 号：R654.2[医药卫生—外科学]