采用左心房顶部进路纠治心上型完全性肺静脉异位连接  

Superior approach of supracardiac total anomalous pulmonary venous connection repair

作　　者：徐志伟[1] 苏肇伉[1] 王顺民[1] 陈会文[1] 丁文祥[1] 

机构地区：[1]上海第二医科大学附属新华医院上海儿童医学中心,200127

出　　处：《中华小儿外科杂志》2004年第1期32-34,共3页Chinese Journal of Pediatric Surgery

摘　　要：目的　评估经左房顶部进路方法纠治心上型完全性肺静脉异位连接。方法　 2 0 0 1年11月至 2 0 0 3年 1月 ,采用经左房顶部进路方法纠治心上型完全性肺静脉异位连接 16例。年龄 (2 3d～ 4岁 ) ,其中 6个月以下 8例 ,占 5 0 .0 % ;平均体重 (8.5± 4 .94 )kg ,10kg以下共 11例 ,占全组6 8.7%。结果　纠治心上型完全性肺静脉异位连接 16例 ,无死亡。其中 1例术后吻合口狭窄 ,第 2d再次手术 ,肺静脉回流通畅 ,康复出院。 1例婴儿术后做膈肌折叠术。 2例新生儿术后延迟关胸。术后随访 3～ 16个月 ,所有患儿生长发育良好 ,胸片示心影较术前明显缩小 ,肺充血消失 ,心电图示窦性节律 ,无一例出现肺静脉回流梗阻。结论　采用经左房顶部进路方法纠治心上型完全性肺静脉异位连接 ,取得较好效果。手术成功取决于左房与汇总静脉的吻合口大小 ,保证肺静脉回流无梗阻。Objective To review the surgical repair of supracardiac type of total anomalous pulmonary venous connection by the superior approach.Methods From November 2001 to January 2003, sixteen patients with supracardiac type of total anomalous pulmonary venous connection were repaired by the superior approach. The age ranging from 23 day to 4 years, 8 patients (50%) were less than 6 month of age; the weight was 8.5± 4.94?kg,11 patients were less than 10?kg.Results There was no death. One patient had obstruction of pulmonary venous return after operation, redo the anastomosis again at second day and this patient was successful. One baby had postoperative diaphragm paralysis and diaphragm placation was performed. Two neonates had delayed wound closure after surgery. The patients were followed up for 3～16 months. ECG showed sinus rhythm, Echo showed no pulmonary venous return obstruction and good heart function.Conclusions Surgical repair of supracardiac type of total anomalous pulmonary venous connection by the superior approach yields good result. Prognosis depends upon adequate anastomosis between the common vein and left atrium and no obstruction of pulmonary venous return.

关 键 词：左心房顶部 手术入路 心上型 肺静脉畸形 心脏外科手术 儿童 

分 类 号：R726.5[医药卫生—儿科]