浅低温体外循环心脏不停跳修复成人房间隔缺损181例  

Surgery on pump with heart beating of 181 adults with atrial septal defect

作　　者：马瑞彦[1] 肖颖彬[1] 钟前进[1] 陈林[1] 王学锋[1] 

机构地区：[1]第三军医大学新桥医院心血管外科,重庆400037

出　　处：《心肺血管病杂志》2004年第1期6-8,共3页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的 :总结 1999年 1月至 2 0 0 3年 4月 181例 16岁以上成人房间隔缺损手术治疗病例 ,探讨成人房间隔缺损的外科治疗的方法和经验。方法 :采用浅低温体外循环心脏不停跳技术行房间隔缺损修补手术 ,其中男 5 5例 ,女 12 6例 ,年龄 16～ 6 2岁 ;合并部分肺静脉异位引流 18例 ,三尖瓣关闭不全2 0例 ,二尖瓣关闭不全 12例 ,左上腔静脉 18例 ;补片修补房缺者 112例 ,其余病例均直接缝合修复 ,合并心内畸形均同期矫治。结果 :手术后早期二次开胸止血 3例 ;切口脂肪液化 2例 ,心包积液 3例 ,心律失常 12例 ,全组无死亡病例。结论 :成人房间隔缺损根据临床表现和超声心动图可明确诊断。一旦明确手术适应症 ,应该积极手术治疗 ,早期手术可以降低心律失常的发生 ,减少术后并发症 ,提高生活质量。心脏不停跳心内直视手术可作为安全可靠的方法应用于成人房间隔缺损的外科治疗 。Objective:To discuss surgical of 181 adults, who were more than 16 years old and underwent atrial septal defect (ASD) between January 1999 and April 2003. Method:Among 181 cases, 55 males,126 females,aged from 16 to 62 years, mainly with simple ASD, associated with partial anomalous pulmonary venous connection (PAPVC) in 18 cases, atrioventricular valve regurgitation in 32 cases and left super vena cava in 18 cases. 112 cases underwent repair with patches on ASD.Result:3 cases underwent second thoracotomy for bleeding , cardiac arrhythmia in 12 cases,incision fat colliquation occurred in 2 cases,pericardial effusion in 3 cases and no death occured. Conclusion:Operation should be performed on adults with ASD when the operation indication is confirmative . The earlier the operation is performed, the less the complicatuions occurred. Beating heart surgery on pump may be safe and reliable procedure for adults with ASD.

关 键 词：浅低温 体外循环 心脏不停跳修复 成人 房间隔缺损 心脏外科手术 

分 类 号：R654.2[医药卫生—外科学]