肺血增多型三尖瓣闭锁的外科治疗  

The surgical treatment of tricuspid atresia with increased pulmonary blood flow

作　　者：毛俊[1] 许耀强[1] 段蔚然 李磊[1] 刘爱军[1] 李刚[1] 程沛[1] 范祥明[1] 苏俊武 MAO Jun;XU Yao-qiang;DUAN Weiran;LI Lei;LIU Aijun;LI Gang;CHENG Pei;FAN Xiangming(Department of Paediatric Cardiology,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart,Lung and Blood Vessel Diseases,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所小儿心脏中心,100029 [2]不详

出　　处：《心肺血管病杂志》2020年第8期975-978,共4页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:分析肺血增多型三尖瓣闭锁患者行肺动脉环缩术后的临床随访结果。方法:入选自2010年6月至2019年12月在本中心接受肺动脉环缩术的三尖瓣闭锁患者共22例,其中男性15例,女性7例。依据年龄分为1岁以内组(13例)和1岁以上组(9例)。行肺动脉环缩术后,随访并比较其临床结果。结果:患者手术时中位年龄为8.0(5.8,18.5)个月,平均体质量为(8.5±3.8)kg。术后肺动脉收缩压及肺动脉平均压均较术前明显下降。1岁以下患者和1岁以上患者手术前后的肺动脉收缩压、肺动脉平均压、术后呼吸机使用时间和住重症监护室时间无明显差异。围术期死亡1例(4.5%)。术后随访时间(80.6±35.1)个月。共9例(41%)完成Glenn术。结论:对于肺血增多型三尖瓣闭锁患者,早期行肺动脉环缩术是一种安全有效的治疗手段。Objective:To analyze the result of pulmonary artery banding in patients with tricuspid atresia associated with increased pulmonary blood flow.Methods:22patients(15 males and 7 females)with tricuspid atresia associated with increased pulmonary blood flow who underwent pulmonary artery banding in our hospital between June 2010 to December 2019 were enrolled.Patients were divided into two groups according to the age:≤1 year old(n=13)and>1 year old(n=9).The follow-up result were compared.Results:The age when patients underwent surgery was 8.0(5.8,18.5)month,the weight was(8.5±3.8)kg.The systolic pulmonary artery pressure and mean pulmonary artery pressure was significant decline after surgery.Between patients who younger than 1 years old and older than 1 years old,the systolic pulmonary artery pressure and mean pulmonary artery pressure before or after surgery,the duration of mechanical ventilation and icu stay has no significant difference.1 patient(4.5%)died perioperatively.During the follow-up of(80.6±35.1)months,9 patients(41%)underwent Glenn surgery.Conclusions:For patients with tricuspid atresia associated with increased pulmonary blood flow,the pulmonary artery banding is a relatively safe and effective treatment.

关 键 词：先天性心脏病 三尖瓣闭锁 肺动脉环缩术 分期手术 

分 类 号：R54[医药卫生—心血管疾病]