儿童无顶冠状静脉窦综合征的外科治疗  

Surgical treatment of pediatric unroofed coronary sinus syndrome

作　　者：童峰[1] 郑佳[1] 宋振江[1] 柏松[1] 李晓峰[1] Tong Feng;Zheng Jia;Song Zhenjiang;Bai Song;Li Xiaofeng(Department of Cardiac Surgery,Beijing Children′s Hospital Affiliated to Capital Medical University,Beijing 100045,China)

机构地区：[1]首都医科大学附属北京儿童医院心脏外科,北京100045

出　　处：《中华实用儿科临床杂志》2019年第13期990-992,共3页Chinese Journal of Applied Clinical Pediatrics

摘　　要：目的分析儿童无顶冠状静脉窦综合征( UCSS)的临床特点和外科手术治疗方法,为此类疾病围术期的诊治提供经验.方法回顾性分析2011年1月至2017年12月在首都医科大学附属北京儿童医院手术治疗的13例UCSS患儿的临床资料.13例患儿均合并永存左上腔静脉( PLSVC)和其他心脏畸形;其中术前诊断7例,术中诊断6例.根据Kirklin分型诊断Ⅰa型11例,Ⅳa型2例;手术均采用房间隔重建术,引流左上腔静脉(LSVC)至右心房,手术同期矫治合并的其他心脏畸形.结果本组术后死亡1例,余12例患儿术后早期恢复顺利.术后呼吸机辅助时间5~264 h(中位数29 h);住院时间8~40 d(中位数16 d).随访12例,随访时间6个月~7年2个月,无死亡和并发症发生,无残余分流和残余梗阻.结论先天性心脏病并PLSVC时,要警惕UCSS的存在.儿童UCSS行房间隔重建术,引流LSVC汇入右心房的手术方式可获得满意的手术效果.Objective To analyze the clinical features and surgical treatment of unroofed coronary sinus syn-drome(UCSS)in children,and to provide evidence for the diagnosis and treatment of such diseases during the perio-perative period. Methods A retrospective analysis was conducted based on the clinical data of 13 patients with UCSS, who underwent surgical treatment at Beijing Children's Hospital Affiliated to Capital Medical University from January 2011 to December 2017. All 13 patients were complicated with persistent left superior vena cava( PLSVC)and other cardiac malformations;7 patients were diagnosed preoperatively and 6 patients were diagnosed intraoperatively. Eleven cases were diagnosed typeⅠand 2 cases were typeⅣaccording to Kirklin's classification. In all of 13 cases,atrial sep-tal reconstruction was performed to drain the left superior vena cava(LSVC)to the right atrium,and other cardiac mal-formations were corrected at the same time. Results One patient died in this group,and the other 12 patients had early recovery after operation. Postoperative-ventilator-assisted time was 5-246 h( median 29 h)and hospital stay time was 8-40 d(median 16 d). The remaining 12 cases were followed up from 6 months to 7 years and 2 months. No death or complications occurred. No residual shunt or residual obstruction was found. Conclusions In the case of congenital heart disease with PLSVC,UCSS should be alerted. Atrial septal reconstruction and drainage of LSVC into right atrium in children with UCSS can achieve satisfactory surgical results.

关 键 词：儿童 无顶冠状静脉窦综合征 外科手术 永存左上腔静脉 

分 类 号：R726.5[医药卫生—儿科]