86例完全型房室间隔缺损外科手术疗效分析  

Surgical repair of complete atrioventricular septal defect in 86 patients

作　　者：谢立[1] 黄灿[1] 赵天力[1] 杨进福[1] 吴忠仕[1] 杨一峰[1] 宋逢林[1] 

机构地区：[1]中南大学湘雅二医院心脏大血管外科,长沙410011

出　　处：《中国医师杂志》2016年第8期1152-1155,共4页Journal of Chinese Physician

基　　金：国家自然科学基金（81500245）

摘　　要：目的 总结86例完全型房室间隔缺损（CAVSD）患者外科手术治疗的早期疗效.方法 2007年1月至2014年12月在本科接受外科治疗的86例CAVSD患者.其中男44例,女42例;年龄1个月至17岁,平均（32.3±46.5）个月,其中＜6个月24例,≥6个月62例;身高53 ～ 165（82.1 ±27.6）cm;体重4.1 ～43（10.8±8.7）kg.Rastelli分型：A型67例,B型15例,C型4例.合并21-三体综合征6例.术前房室瓣反流轻度32例,中度38例,中重度16例.肺动脉高压轻度15例,中度54例,重度17例.结果 86例患儿采用双片法外科矫治69例,采用单片下压法17例.术后所有患儿均入重症监护室继续治疗,呼吸机辅助2.5～244（30.9±47.7）h.监护室停留时间14～306（87.7±76.8）h.住院时间6～50（16.4±9.2）d.全组术后死亡4例（4.7％）,其中双片法外科治疗组3例,单片下压法外科治疗组1例;4例患儿均死于术后瓣膜反流加重,多器官功能衰竭.结论 双片法和单片下压法治疗CAVSD均可取得满意的手术早期疗效.Objective To investigate the early surgical outcomes of 86 patients with complete atrioventricular septal defect.Methods Between January 2007 and December 2014,consecutive 86 cases received surgical repair in our department.There were 44 male patients,and 42 female patients.Two-patch repair was performed in 69 cases,and modified single-patch repair in 17 cases.The mean age,height,and weight at the time of operation were （32.3 ± 46.5）months with a range from 1 month to 17 years,（82.1 ±27.6） cm with a range from 53 to 165 cm,and （10.8 ± 8.7） kg with a range from 4.1 to 43 kg,respectively.Rastelli A type was found in 67 cases,B type in 15 cases,and C type in 4 cases.Down＆#39;s syndrome was complicated in 6 cases.Preoperative mild regurgitation of common atrioventricular valve was shown in 32 cases,moderate regurgitation in 38 cases,and moderate to severe regurgitation in 16 cases.Mild pulmonary hypertension was observed in 15 cases,moderate in 54 cases,and severe in 17 cases.Results After operation,all patients were sent into intensive care units （ICU）.The mean duration mechanical ventilation,ICU stay,and hospitalization were （30.9 ± 47.7） h with a range from 2.5 to 244 h,（87.7 ± 76.8） h with a range from 14 to 306 h,and （16.4 ±9.2）d with a a range from 6 to 50 d,respectively.We encountered 4 operatively mortalities （4.7%）,including 3 in two-patch repair group,and 1 in modified single-patch repair group.The cause of death was mitral regurgitation.Conclusions Modified single-patch and two-patch technique have a satisfied early outcomes.

关 键 词：心间隔缺损 外科学 

分 类 号：R654.2[医药卫生—外科学]