新鲜自体心包塑型三瓣叶肺动脉管道的临床回顾性研究  

Retrospective Clinical Study of Fresh Autologous Pericardial Reconstructing Tri-leaflet Pulmonary Artery Conduit in Relevant Patients

作　　者：伊寒露 李晓峰[1] 柏松[1] 郭健[1] 丁楠[1] 郑佳[1] 

机构地区：[1]首都医科大学附属北京儿童医院心脏外科,北京市100045

出　　处：《中国循环杂志》2017年第4期380-383,共4页Chinese Circulation Journal

摘　　要：目的:总结18例新鲜自体心包塑型三瓣叶肺动脉管道在婴幼儿右心室流出道重建术中的应用及效果。方法:随访2007-08至2016-07期间,18例应用新鲜自体心包塑型三瓣叶肺动脉管道行右心室流出道重建的复杂先天性心脏病患儿,男10例,平均年龄(2.12±2.02)岁,平均体重≥(9.41±3.62)kg。患儿术后1个月、3~6个月和≥12个月,接受超声心动图复查等随访观察。结果:18例患儿手术均成功。术后早期死亡2例,1例因并发严重感染、呼吸衰竭死亡,1例因合并低心排综合征死亡。存活的16例患儿平均重症监护病房驻留时间(140.2±124.5)h,平均呼吸机辅助通气时间(94.4±87.6)h,术后安静不吸氧状态下测经皮氧饱和度平均为(97.1±3.34)%。术后随访1个月、3~6个月和≥12个月,失访3例,共13例定期复查,X线胸片未见明确钙化点,心脏彩色多普勒超声心动图测量各处直径结果显示右心室流出道狭窄、肺动脉瓣环狭窄、主肺动脉狭窄均少见,左、右肺动脉狭窄次之。结论:新鲜自体心包塑型三瓣叶肺动脉管道在婴幼儿右心室流出道重建术中的安全性和有效性可满足临床治疗要求,中长期效果有待进一步随访和观察。Objective： To summarize the application and efficacy of fresh autologous pericardial tri-leaflet pulmonary artery conduit for right ventricular outflow tract reconstruction in patients with complex congenital heart disease （CHD）. Methods： A total of 18 relevant patients received fresh autologous pericardial tri-leaflet pulmonary artery conduit for right ventricular outflow tract reconstruction in our hospital from 2007-08 to 2012-12 were studied. The patients were at the mean age of （2.12±2.02） years with body weight ≥ （9.41±3.62） kg including 10 male. Echocardiography was followed-up at 1 month, 3-6 and ≥12 months post-operation. Results： All 18 patients had successful operation. 2 patients died at early post-operative stage including 1 with severe infection and respiratory failure, 1 with low cardiac output syndrome. 16 survivors had the average ICU stay time （140.2±124.5） h, mechanical ventilation （94.4±87.6） h, transcutaneous O2 saturation at quiet condition without O2 inhalation at （97.1±3.34） %. There were 3 patients lost contact during followed-up period and 13 received periodical examination. No obvious calcification was found in chest X-ray; echocardiography showed infrequent stenosis of right ventricular outflow tract, pulmonary valve ring and main pulmonary artery; left and right pulmonary artery stenosis at the second place. Conclusion： The safety and efficacy of fresh autologous pericardial tri-leaflet pulmonary artery conduit for right ventricular outflow tract reconstruction was fine for treating relevant patients, the mid and long term effect should be further observed.

关 键 词：移植 自体 右心室流出道重建 

分 类 号：R541[医药卫生—心血管疾病]