全腔静脉肺动脉连接术应用成年患者近远期临床结果分析  

Clinical Result of Total Cavopulmonary Connection at Adults

作　　者：胡小松[1] 杨克明[1] 李守军[1] 许建屏[1] 吕小东[1] 

机构地区：[1]北京协和医学院中国医学科学院阜外医院国家心脏病中心心血管病研究所,北京100037

出　　处：《中国分子心脏病学杂志》2016年第3期1714-1717,共4页Molecular Cardiology of China

摘　　要：目的研究全腔静脉肺动脉连接术应用于成年患者临床效果并分析影响因素。方法回顾性分析2001年1月至2015年12月在阜外医院行全腔静脉肺动脉连接术的成年(年龄≥14岁)患者75例的围手术期临床资料。分析是否开窗、是否分期手术、不同手术方式等对早期及中远期结果影响,分析影响生存率的危险因素。结果早期死亡5例(6.7%),随访期间死亡1例,平均随访时间42.5±34.7月,随访期间患者心功能明显好于术前(P<0.001)。危险因素分析体外循环时间(P=0.049),血液透析(P=0.004)是早期死亡危险因素;整体死亡危险因素有血液透析(P=0.010),房室瓣中度及以上返流(P=0.010)。而不同手术方式(P=0.729、0.973)、一期或者分期全腔(P=0.494、0.300)、是否开窗(P=0.486、0.998)、是否伴随其他手术(P=0.494、0.596)对早期、整体死亡影响无统计学差异。结论符合条件的成年患者行全腔静脉肺动脉连接术临床效果良好。Objective Study the morbidity and mortality at adults undergoing Total cavopulmonary connection and assessed risk factors for mortality. Methods Data from 75 patients （age≥14years） underwent Total cavopulmonary connection from January 2001 to December 2015 were retrospectively analyzed. Compared the outcomes between the different groups （fenestrated or not, extracardiac conduit cavopulmonary connection or lateral tunnel cavopulmonary connection, by stages operation or not）. Results There are 5 hospital deaths （mortality： 6.7%） and 1 later death. The mean follow up times were 42.5±34.7mouth. New York Heart Association functional class had improved significant （P〈0.001）. Independent risk for mortality were cardiopulmonary bypass time （P=0.009）, hematodialysis （P=0.004）. Risk factors for overall mortality were hematodialysis（P=0.010） and atrioventricular valve regulation （P=0.010）. ET-TCPC or LT-TCPC （P=0.729, 0.973）, fcnestrated or not（P=0.486, 0.998）, by stages operation or not（P=0.494,0.300） haven＇t significant effect early and overall mortality. Conclusion The outcomes of TCPC for selects adults patients are encouraging.

关 键 词：先天性心脏病 全腔静脉肺动脉连接术 成年人 

分 类 号：R654.2[医药卫生—外科学]