双片法和Warden法矫治部分型肺静脉异位引流的对比分析  

Comparative analysis of the treatment of partial anomalous pulmonary vein connection by double-patch method or Warden Technique

作　　者：王执一 吴永涛[1] 杨尧[1] 王栋[1] 金灿 范祥明[1] Wang Zhiyi;Wu Yongtao;Yang Yao;Wang Dong;Jin Can;Fan Xiangming(Department of Pediatric Cardiology,Capital Medical University Affiliated Beijing Anzhen Hospital,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小儿心脏中心,北京市心肺血管疾病研究所,100029

出　　处：《中华胸心血管外科杂志》2021年第12期729-732,共4页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：目的比较双片法和Warden法矫治右肺静脉异常连接至上腔静脉的部分型肺静脉异位引流的手术效果及远期随访结果。方法回顾分析2010年5月至2019年5月在北京安贞医院小儿心脏中心行双片法或Warden法矫治的右肺静脉异常连接至上腔静脉的部分型肺静脉异位引流病例共33例,其中双片法21例,Warden法12例,术后定期随访超声心动图及心电图,观察是否发生心律失常、上腔静脉狭窄和肺静脉狭窄。结果全组患者顺利出院,术后随访1~8年。双片组2例围术期心律失常,其中1例为交界性心律,术后1天自行转复窦性心律,另1例术后早期Ⅱ度房室传导阻滞,使用临时起搏器3天后恢复窦性心律。1例复查超声心动图示上腔静脉狭窄(压差8 mmHg,1 mmHg=0.133 kPa)。Warden组术后远期随访未见心律失常;2例复查超声心动图出现上腔静脉狭窄(压差6 mmHg);1例超声心动图提示出现右肺静脉狭窄(压差8 mmHg),远期随访未见明显加重。结论双片法和Warden法在治疗肺静脉异常连接至上腔静脉的部分型肺静脉异位引流上均安全有效。Objective To compare the surgical and long-term follow-up results of partial anomalous pulmonary vein connection treated by double-patch method or Warden Technique.Methods There were 33 cases of right pulmonary vein connected with the superior vena cava from May 2010 to May 2019 in our center treated by double-patch method or Warden technique.21 cases were treated by double-patch method and 12 cases by Warden technique.Echocardiography and electrocardiogram were followed up regularly to observe the occurrence of arrhythmia,superior vena cava stenosis and pulmonary vein stenosis postoperatively.Results All patients were discharged uneventfully,and were followed up for 1~8 years.In double-patch group,2 cases with arrhythmia,1 of whom was junctional arrhythmia which was automatically converted to sinus rhythm 1 day after surgery.The other had an early second degree atrioventricular block after surgery,and sinus rhythm was restored 3 days later with temporary pacemaker.1 case had superior vena cava stenosis by echocardiography(PD 8 mmHg).No arrhythmia was found in long-term follow-up in Warden group.2 cases had superior vena cava stenosis by echocardiography(PD 6 mmHg).Right pulmonary vein stenosis(PD 8 mmHg)was found in 1 case by echocardiography,no obvious aggravation was found in long-term follow-up.Conclusion The double-patch method and Warden Technique are both safe and effective in the treatment of partial anomalous pulmonary venous connection.

关 键 词：部分肺静脉异位引流 外科治疗 心律失常 体静脉狭窄 肺静脉狭窄 

分 类 号：R726.5[医药卫生—儿科]