室间隔缺损修补术中三尖瓣适当切开技术的临床应用  

Application of tricuspid valve detachment for ventricular septal defect

作　　者：韦小勇[1] 严中亚[1] 朱正艳[1] 雷虹[1] 吴一军[1] 卢中[1] 孙云[1] 

机构地区：[1]安徽医科大学附属省立医院心脏外科,合肥230001

出　　处：《安徽医科大学学报》2016年第8期1218-1221,共4页Acta Universitatis Medicinalis Anhui

基　　金：安徽省科技厅2013年科技计划项目(编号:1301042198)

摘　　要：回顾性分析近5年行膜周部室间隔缺损(VSD)修补的1 263例患者的临床资料,分为三尖瓣适当切开技术(TVD)组(537例)与非TVD组(726例),比较两组术后残余分流、传导阻滞、三尖瓣返流等的发生率。两组围手术期无死亡病例,主动脉阻断时间、体外循环时间等差异无统计学意义;TVD组发生一过性房室传导阻滞10例,无完全性房室传导阻滞;非TVD组发生一过性房室传导阻滞35例,完全性房室传导阻滞2例。术后随访TVD组发生VSD小量残余漏2例,非TVD组11例;TVD组发生轻度以上三尖瓣返流(TR)7例,非TVD组9例。两组患者VSD修补术后一过性传导阻滞、残余漏及总计并发症情况比较,差异有统计学意义(P<0.05)。TVD是一安全有效的技术,能显著改善VSD暴露,减少并发症,且不影响三尖瓣的正常功能。A total of 1 263 perimembranous VSD patients were analyzed retrospectively, including 537 of TVD （TVD group） and 726 of non-TVD （non-TVD group）. The incidences of residual shunt, atrioventricular block and tricuspid regurgitation（TR） were compared between the two groups. No death occurred in all patients. Temporary heart block was 10 in TVD group and 35 in non-TVD group, and complete atrioventricular block was 0 and 2. There were 2 patients who had trivial residual shunt in TVD group but 11 in non-TVD group. Mild TR during postoperation follow-up was 7 in TVD group and 9 in non-TVD group. There were statistically significant differences of the temporary heart block, residual shunt and total complication between the two groups （P 〈 0. 05 ）. TVD is a safe and valuable technique for closure of perimembranous VSDs, which can improve the VSD exposure and reduce its complication, but have no influence for the relatively normal function of the tricuspid valve.

关 键 词：膜周部室间隔缺损 三尖瓣适当切开技术 三尖瓣返流 残余漏 

分 类 号：R654.2[医药卫生—外科学]