双向格林术在婴儿复杂先心病中的应用  

Application of bidirectional Glenn procedure to treat complex congenital heart disease in infants

作　　者：郑家永 张岩伟 艾峰[1] 范太兵[1] 彭帮田[1] 

机构地区：[1]河南省人民医院儿童心脏中心,郑州450003

出　　处：《医药论坛杂志》2016年第4期21-22,26,共3页Journal of Medical Forum

摘　　要：目的探讨双向格林手术治疗婴儿复杂先心病的临床特点及手术效果。方法选取2006年7月至2014年5月,40例在体外并行循环下行双向格林（Glenn）术的复杂先天性心脏病患儿病例。其中男性23例,女性17例。年龄3个月-1岁,平均年龄（0.73±0.21）岁,体表面积（0.28±0.06）m^2。术前经皮血氧饱和度（75±6）%,术前肺动脉压（12.12±3.42）mm Hg。结果全组无死亡,术后出现并发症5例（胸腔积液3例,乳糜胸2例）。术后肺动脉压（18.34±2.52）mm Hg,经皮血氧饱和度（84±7）%。结论对于难以解剖根治或I期Fontan手术的紫绀型肺血减少的复杂先心病患儿,双向Glenn手术是一种简单、可靠的手术方式,可缓解患儿早期的缺氧状况,促进肺血管发育,为二期手术创造了机会。提倡对于难以Ⅰ期根治的复杂先天性心脏病早期干预是安全可行的。Objective To investigate the outcomes and clinical characteristics of bidirectional Glenn procedure to treat complex congenital heart disease in infants. Methods Between July 2006 and May 2014,40 patients with complex cyanotic congenital heart defects underwent bidirectional Glenn operations with cardiopulmonary bypass at this cente L. including 23 males and 17 females,ranging from 3 months to 1 year old age with an average age（ 0. 73 ± 0. 21） years old age,and mean body surface area（ 0. 28 ± 0. 06） m^2. Before surgery,mean transcutaneous oxygen saturation was（ 75 ±6） %,and mean pulmonary pressure was（ 12. 12 ± 3. 42） mm Hg. Results All patients survived,and 5 patients suffered severe complications（ 3 cases of pleural effusion,2 cases of chylothorax）. After surgery,mean transcutaneous oxygen saturation was（ 84 ± 7） %,and mean pulmonary pressure was（ 18. 34 ± 2. 52） mm Hg. Conclusion Bidirectional Glenn procedure is a safe and effective method,for complicated congenital heart diseases in infants with inadequate pulmonary blood flow when anatomical correction and stage I Fontan operation are not suitable. It can improve infantwith early hypoxia,create opportunities for after surgery,that complex congenital heart disease should be early intervention.

关 键 词：双向格林术 婴儿 复杂先心病 

分 类 号：R725.4[医药卫生—儿科]