心外管道全腔静脉肺动脉吻合术治疗复杂性先天性心脏病  

Surgical treatment of the complex congenital heart disease with the extracardiac conduit total cavopulmonary anastomosis

作　　者：楚军民[1] 吴清玉[1] 

机构地区：[1]中国医学科学院中国协和医科大学阜外心血管病医院心血管病研究所心血管外科,北京100037

出　　处：《中国胸心血管外科临床杂志》2003年第4期241-243,共3页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

摘　　要：目的　评价心外管道全腔静脉肺动脉吻合术 (TCPA)治疗复杂先天性心脏病的临床应用价值。　方法　1998年 6月～ 2 0 0 2年 7月 ,2 6例先天性心脏病复杂畸形的患者接受了心外管道 TCPA,包括单心室伴完全型大动脉转位 16例 ,三尖瓣下移畸形 2例 ,右心室双出口伴大动脉转位 3例 ,三尖瓣闭锁伴右心室发育不良 5例。 19例在全身麻醉低温体外循环下手术 ,7例在非体外循环下手术。　结果　无手术死亡 ,全部患者治愈出院。术后随访 1～ 4 7个月 ,无晚期死亡。所有患者症状消失 ,无静脉压明显升高现象 ,超声心动图检查示心外管道血流通畅 ,无血栓形成 ,心电图检查示无严重的心律失常 ,血氧饱和度 0 .93～ 0 .96 ,心功能均达 ～ 级。　结论　心外管道 TCPA是一种较为简单的手术方式 ,易于掌握 ;术后疗效满意 ,优于其他术式。Objective To evaluate the value of application of extracardiac conduit total cavopulmonary anastomosis(TCPA) in treatment for complex congenital heart disease. Methods From June 1998 to July 2002, 26 patients underwent extracardiac conduit TCPA for complex congenital heart diseases. Among them, 16 had functional univentricle with transposition of the great artery (TGA),2 had Ebstein's anomaly,3 had double outlet of right ventricle (DORV) with TGA, 5 had tricuspid atresia with hypoplasia of right ventricle. 19 surgical procedures were performed under cardiopulmonary bypass with general anesthesia and hypothermia, 7 surgical procedures were performed without cardiopulmonary bypass. Results There was no early death and no postoperative deaths. All patients were followed up for 1 to 47 months with no clinical symptoms. There was no evidence of high level systemic venous pressure. Electrocardiogram revealed no arrhythmias. The arterial oxygen saturation (SaO 2) were 0.93- 0.96, the cardiac function were in NYHA class Ⅰ-Ⅱ. Conclusion The extracardiac conduit TCPA is a simple procedure, it is easy to perform. Compared with other type of surgery, it has more advantages.

关 键 词：心外管道 全腔静脉肺动脉吻合术 手术治疗 复杂性先天性心脏病 体外循环 全身麻醉 

分 类 号：R654.2[医药卫生—外科学]