复杂先心病右心室双出口外科治疗效果分析  

Therapeutic effect of surgical treatment on complex congenital heart disease with double outlet of right ventricle

作　　者：谢业伟[1] 张儒舫[1] 沈立[1] 李小兵[1] 龚瑾[1] Xie Yewei;Zhang Rufang;Shen Li;Li Xiaobing;Gong Jin(Department of Cardiothoracic Surgery,Children's Hospital,Shanghai Jiaotong University,Shanghai 200062,China)

机构地区：[1]上海交通大学附属儿童医院心胸外科,上海200062

出　　处：《中国循证心血管医学杂志》2018年第8期944-946,949,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：上海市科技计划项目资助(17411969000)

摘　　要：目的分析右心室双出口(DORV)个案化治疗的效果。方法纳入2008年7月~2017年7月就诊于上海交通大学附属儿童医院心胸外科96例接受右心室双出口外科治疗的患儿,根据患儿不同的DORV解剖类型对其制定个案化的手术方案。结果所有患儿中,死亡4例,死亡率4.2%,并发症有主动脉瓣返流、心包积液、左室流出道梗阻、右室流出道梗阻。左心室发育不良或左室射血分数(LVEF)<50%、左右心室发育不均衡、手术年龄及体重过低都会增加手术的风险性。结论大多数右心室双出口患儿都可进行双心室根治手术,合理、个案化的手术方案更有助于降低DORV患者的手术风险,根据患者具体的DORV解剖类型选择合适的手术方案,是手术成功的关键。Objective To analyze the curative effect of individualized treatment on double outlet of right ventricle(DORV).Methods The child patients(n=96)received surgical treatment of DORV were chosen from the Department of Cardiothoracic Surgery of Children’s Hospital affiliated to Shanghai Jiaotong University from July 2008 to July 2017.According to anatomical types of DORV,the individualized surgical plans were made for the child patients.Results Of all child patients,4 died and mortality rate was 4.2%.The postoperative complications included aortic regurgitation,pericardial effusion,left ventricular outflow tract obstruction and right ventricular outflow tract obstruction.Left ventricular dysplasia,left ventricular ejection fraction(LVEF)<50%,inequality of left and right ventricular,age and low weight increased risk of the surgery.Conclusion The most of DORV patients can be given radical surgery,and reasonable and individualized surgical plan is more helpful in reducing the risk of surgery.It is a key for successful surgery to select applicable surgical plan according to DORV anatomical types.

关 键 词：右心室双出口 手术治疗 个案化治疗 解剖类型 

分 类 号：R541[医药卫生—心血管疾病]