12例一侧肺动脉异常起源于升主动脉的外科治疗总结  

An analysis of 12 cases of surgical treatment of anomalous origin of pulmonary artery from the ascending aorta

作　　者：陈奇童 肖红艳 宋来春 陶凉 CHEN Qi-tong;XIAO Hong-yan;SONG Lai-chun;TAO Liang(Department of Cardiac Surgery,Wuhan Asian Heart Hospital Affiliated to Wuhan University of Science and Technology,Wuhan 430022,China)

机构地区：[1]武汉科技大学附属武汉亚洲心脏病医院心脏外科,湖北省武汉市430022

出　　处：《中国心血管病研究》2021年第7期608-612,共5页Chinese Journal of Cardiovascular Research

基　　金：武汉市科技计划项目(2020020601012317)。

摘　　要：目的分析一侧肺动脉异常起源于升主动脉的外科治疗疗效。方法回顾性分析我院2000年至2020年因一侧肺动脉异常起源于升主动脉行外科治疗的12例患者临床资料,其中男性8例,女性4(33.3%)例。年龄1月~42岁,平均(6.77±11.94)岁。体重3.5~58.0 kg,平均(15.45±16.06)kg。左肺动脉起源异常(AOLPA)2例,右肺动脉起源异常(AORPA)10例,其中合并房间隔缺损(ASD)5例,室间隔缺损(VSD)1例,卵圆孔未闭(PFO)2例,动脉导管未闭(PDA)9例,法洛四联症(TOF)2例,右心室双出口(DORV)1例,二尖瓣关闭不全(MR)1例,三尖瓣关闭不全(TR)5例。结果12例患者均行外科手术治疗,合并其他畸形术中同期处理,其中3例合并其他复杂先天性心脏畸形的患者术后因心力衰竭术后而死亡。体外循环时间79~310 min,平均(137.83±69.92)min;主动脉阻断时间34~130 min,平均(77.08±29.21)min;ICU停留时间38~427 h,平均(113.17±119.58)h;术前超声估计肺动脉压力,平均(81.00±34.34)mmHg(1 mm Hg=0.133 kPa),术后及随访期间肺动脉压力均大致正常。术后随访时间9~97个月,平均(26.17±35.71)月,随访期间未发现肺动脉狭窄现象。结论肺动脉起源异常于升主动脉应尽早行外科手术治疗,可改善患者远期预后及生活质量。Objective To evaluate the curative effect of surgical treatment of anomalous origin of pulmonary artery from the ascending aorta(AOPA).Methods 12 cases of the patients with AOPA who underwent surgical treatment in our hospital from 2000 to 2020 were retrospectively analyzed.There were 8 males and 4 females(33.3%)with the age of one month to 42 years[mean,(6.77±11.94)kg]and the body weight of 3.5~58.0 kg[mean,(15.45±16.06)kg].2 cases were left pulmonary artery origin abnormality(AOLPA)and 10 cases were right artery origin abnormality(AORPA).5 cases associated with atrial septal defect(ASD),1 with ventricular septal defect(VSD),2 with patent foramen ovale(PFO),9 with patent ductus arteriosus(PDA),2 with tetralogy of Fallot(TOF),1 with right ventricular double outlet(DORV),1 with mitral regurgitation(MR),and 5 with tricuspid regurgitation(TR).Results All 12 patients underwent surgical treatment and the other cardiac malformations were treated at the same time.Three patients with complicated congenital heart malformations died of heart failure after the surgery.The time of extracorporeal circulation was 79~310 min,average(137.83±69.92)min.The time of aortic block was 34~130 min,average(77.08±29.21)min.The post-operative ICU duration was38~427 hours,average(113.17±119.58)hours.Preoperative pulmonary artery pressure was(81.00±34.34)mm Hg(1 mm Hg=0.133 kPa).The pulmonary artery pressure was approximately normal after the surgery and during the follow-up.The postoperative follow-up time was 9~97 months,with an average of(26.17±35.71)months.No pulmonary artery stenosis was found during the follow-up period.Conclusion AOPA patients should receive surgical treatment as soon as possible,which can improve the prognosis and the quality of life.

关 键 词：先天性心脏病 肺动脉起源异常于升主动脉 外科手术 疗效 

分 类 号：R714.5[医药卫生—妇产科学]