心上型完全性肺静脉异位引流的单中心治疗结果  

Treatment of supracardiac total anomalous pulmonary venous connection in a single center

作　　者：王珊[1] 施焘[1] 吕小东[1] 闫军[1] 李守军[1] 花中东[1] WANG Shan;SHI Tao;LV Xiaodong;YAN Jun;LI Shoujun;HUA Zhongdong(Pediatric Cardiac Surgery Center,Fuwai Hospital,National Center for Cardiovascular Diseases,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing,100037,P.R.China)

机构地区：[1]中国医学科学院北京协和医学院国家心血管病中心阜外医院小儿心外科,北京100037

出　　处：《中国胸心血管外科临床杂志》2022年第1期85-89,共5页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：国家重点研发计划资助(2017YFC1308100)。

摘　　要：目的分析心上型完全性肺静脉异位引流的手术治疗结果。方法回顾性分析2014~2019年在本中心行外科手术治疗的98例心上型完全性肺静脉异位引流患者的临床资料,其中男64例、女34例,中位手术年龄3.0(1.5,7.0)个月,中位体重5.0(4.0,6.0)kg。术前肺静脉梗阻23例(23.5%)。传统手术技术治疗92例(93.9%),Sutureless技术治疗6例(6.1%)。采用Cox回归模型分析数据。结果中位随访时间26.50(5.75,44.25)个月。术后死亡9例(9.2%);低体重(P=0.013)、体外循环时间长(P=0.007)为术后死亡的相关因素。8例出现术后肺静脉梗阻(8.2%);低体重(P=0.042)及体外循环时间长(P=0.002)为术后肺静脉梗阻的相关因素。结论本中心外科手术治疗心上型完全性肺静脉异位引流取得较满意的近中期结果。合并低体重、体外循环时间长的病例预后较差。Objective To analyze the surgical results of patients with supracardiac total anomalous pulmonary venous connection(TAPVC)in a single pediatric cardiac center.Methods A retrospective study was conducted on 98 pediatric patients with supracardiac TAPVC receiving surgical repair from 2014 to 2019 in our center.There were 64 males and 34 females with a median surgical age of 3.0(1.5,7.0)months and a median weight of 5.0(4.0,6.0)kg.Twentythree(23.5%)patients had preoperative pulmonary vein obstruction.Ninety-two(93.9%)patients received conventional surgical repair,while six(6.1%)patients were treated with the sutureless technique.The Cox regression model was used to analyze the data.Results The median follow-up time was 26.50(5.75,44.25)months.There were 9(9.2%)deaths.Lower weight at the time of repair(P=0.013)and prolonged cardiopulmonary bypass time(P=0.007)were associated with mortality.Postoperative pulmonary vein obstruction was observed in 8(8.2%)patients.Associated risk factors for postoperative pulmonary vein obstruction included lower weight at the time of repair(P=0.042)and prolonged cardiopulmonary bypass time(P=0.002).Conclusion Surgical repair of supracardiac TAPVC has achieved satisfactory results in our center.Risk factors such as lower weight at the time of repair and prolonged cardiopulmonary bypass time are associated with a poor prognosis.

关 键 词：完全性肺静脉异位引流 心上型 肺静脉梗阻 

分 类 号：R654.2[医药卫生—外科学]