LeCompte操作对大动脉侧侧位Taussig-Bing畸形患儿大动脉调转术后中远期再干预的影响  

The effect of LeCompte maneuver on mid-to-long term reintervention after arterial switch operation in children with side-by-side Taussig-Bing anomaly

作　　者：顾明均 董卫 张文 蒋琪 陈典 胡杰 朱奕帆 胡仁杰 张海波[1] GU Mingjun;DONG Wei;ZHANG Wen;JIANG Qi;CHEN Dian;HU Jie;ZHU Yifan;HU Renjie;ZHANG Haibo(Department of Pediatric Thoracic and Cardiovascular Surgery,Shanghai Children’s Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai,200127,P.R.China)

机构地区：[1]上海交通大学医学院附属上海儿童医学中心心胸外科,上海200127

出　　处：《中国胸心血管外科临床杂志》2023年第10期1433-1439,共7页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：心脏出生缺陷产前产后一体化诊疗学科群(PWZxq2017-14)。

摘　　要：目的探究LeCompte操作对于侧侧位Taussig-Bing畸形行一期大动脉调转术(arterial switch operation,ASO)围术期死亡率及中远期再干预率的影响。方法回顾性分析2006—2017年间于上海儿童医学中心确诊为侧侧位Taussig-Bing畸形行一期ASO患者的临床资料。根据是否行LeCompte操作将患者分为两组:行LeCompte操作组和未行LeCompte操作组;比较两组患者的临床资料。结果共纳入92例患者。行LeCompte操作组32例,男24例、女8例,中位手术年龄65.0 d,平均体重4.3 kg,其中15例(46.9%)合并主动脉弓畸形并同期行修补术,12例(37.5%)合并冠状动脉畸形。未行LeCompte操作组60例,男45例、女15例,中位手术年龄81.0 d,平均体重4.8 kg,其中22例(36.7%)合并主动脉弓畸形,35例(58.3%)合并冠状动脉畸形。行LeCompte操作组的平均体外循环时间与未行LeCompte操作组差异无统计学意义[(179.0±60.0)min vs.(203.0±74.0)min,P=0.093]。行LeCompte操作组院内死亡6例(18.8%),未行LeCompte操作组院内死亡7例(11.7%),差异无统计学意义(P=0.364)。79例患者中位随访时间4.1(1.6,7.5)年,随访期间8例患者失访,无随访死亡。Kaplan-Meier曲线及log-rank检验显示是否行LeCompte操作对中远期总体再干预率(P=0.850)及右室流出道和肺动脉再干预率(P=0.240)差异无统计学意义。结论是否行LeCompte操作对于侧侧位Taussig-Bing畸形患者围术期死亡率及中远期再干预率无显著影响。Objective To explore the effect of LeCompte maneuver on in-hospital mortality and mid-to-long term reintervention after single-stage arterial switch operation in children with side-by-side Taussig-Bing anomaly.Methods Clinical data of patients diagnosed with side-by-side Taussig-Bing anomaly and undergoing single-stage arterial switch operation in Shanghai Children’s Medical Center from 2006 to 2017 were retrospectively analyzed.Patients were divided into two groups based on whether LeCompte maneuver was performed:a LeCompte maneuver group and a non LeCompte maneuver group.The clinical data of two groups were compared.Results Finally 92 patients were collected.LeCompte maneuver was performed in 32 out of 92 patients with a median age of 65.0 days and an average weight of 4.3 kg,among whom 24(75.0%)were male.Fifteen(46.9%)patients received concomitant aortic arch repair while 12(37.5%)patients were associated with coronary artery malformation.LeCompte maneuver was not performed in 60 patients with a median age of 81.0 days and an average weight of 4.8 kg,among whom 45(75.0%)were male.Twentytwo(36.7%)patients received concomitant aortic arch repair while 35(58.3%)patients were associated with coronary artery malformation.The average cardiopulmonary bypass duration of the LeCompte maneuver group showed no statistical difference from the non LeCompte maneuver group(179.0±60.0 min vs.203.0±74.0 min,P=0.093).The inhospital mortality of the two groups were 6(18.8%)and 7(11.7%),respectively,which also showed no statistical difference(P=0.364).The median follow-up period was 4.1(1.6,7.5)years for 79 patients with 8 lost to follow-up,and no death was observed.Kaplan-Meier curve and log-rank test showed no statistical difference in overall mid-to-long term reintervention rate(P=0.850)as well as right ventricular outflow tract and pulmonary artery reintervention rate(P=0.240)with or without LeCompte maneuver.Conclusion Whether or not to perform LeCompte maneuver shows no statistical impact on in-hospital mortality and mi

关 键 词：TAUSSIG-BING畸形 大动脉调转术 再手术 肺动脉狭窄 

分 类 号：R726.5[医药卫生—儿科]