心外带瓣管道在复杂先心病外科治疗中的应用  

The clinical application of extracardiac valved conduits in complex congenital heart disease

作　　者：张仁福[1] 朱洪玉[1] 宫汉东[1] 李新民[1] 李东玉[1] 谭丽丽[1] 

机构地区：[1]沈阳军区总医院心血管外科,110016

出　　处：《中华胸心血管外科杂志》2003年第3期139-141,共3页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：目的　总结心外带瓣管道在复杂先天性心脏病外科治疗中的应用经验。方法　 1979年 9月至 2 0 0 1年 12月 ,采用心外带瓣管道对 131例复杂性先天性心脏病病人行外科治疗。其中同种带瓣管道 2 2例 ,异种 (猪肺动脉瓣 )带瓣管道 73例及抗钙化猪心包瓣管道 36例。结果　全组手术死亡率17 5 %。近 10年手术 6 5例 ,死亡率 10 7%。近 5年手术 44例 ,死亡率 4 5 %。结论　液氮保存的同种带主动脉瓣或肺动脉瓣管道其取材困难 ,而抗钙化猪心包瓣管道可以弥补上述不足 ,还可制成各种型号管道备用。在使用时 ,按心脏病理解剖确定管道置入方法 ,掌握管道尺寸 ,可保持管道完好的几何形状 ,获得更好的血流动力学效果及持久性。Objective: To summarize the experience of clinical application of extracardiac valved tubes in complex congenital heart disease. Methods: From September 1979 to December 2001, 131 patients with complex congenital heart disease underwent surgical treatment by using extracardiac valved tubes, including 22 cases of aortic valved homografts, 73 cases of swine pulmonary valved tubes and 36 cases of extracardiac tubes with anti-calcified swine pericardium valve. Results: The overall mortality rate was 17.5%. The mortality rate has decreased to 10.7% in the late 10 years, and 4.5% in recent 5 years, respectively. Conclusion: It was suggested that aortic and pulmonary valved homograft preserved by liquid nitrogen is the first choice for extracardiac valved tubes. Extracardiac tubes with anti-calcified swine pericardium valve can also be used and they easily available. A better postoperative haemodynamic effect can be achieved by proper placement of the tubes, choice of suitable size and positioning in good geometrical figure.

关 键 词：心外带瓣管道 复杂先心病 治疗 应用 外科手术 血流动力学 

分 类 号：R654.2[医药卫生—外科学]