单心室合并完全性肺静脉异位引流的外科治疗

发布时间：2018-04-13 23:09

本文选题：心脏缺损 + 先天性　；参考：《中国循环杂志》2012年03期

【摘要】：目的:探讨单心室合并完全性肺静脉异位引流(TAPVC)的外科治疗效果。方法:2009-05至2011-09,我科共收治单心室合并TAPVC患儿11例,年龄(30.1±21.4)个月,体重(11.0±3.2)kg。例2行改良B-T分流术,例1、3～6、8、9、11行一侧或双侧双向腔肺分流术,例7、10行一期改良Fontan术。例1、6～9、11同期行TAPVC矫治术。结果:例6、10围术期死亡(18.2%,2/11),死亡原因分别为中枢神经系统感染和多器官功能衰竭。存活的患儿随访1～29个月,例4死亡,余患儿氧饱和度改善,未发现残余肺静脉梗阻,例5行二期改良Fontan术并顺利出院。结论:单心室合并TAPVC患儿仍具有较高早期死亡率,术前明确诊断TAPVC并制定合理的个体化治疗方案是提高手术疗效的关键。
[Abstract]:Objective: to investigate the effect of surgical treatment of single ventricle with complete anomalous pulmonary venous drainage (TAPVC).Methods from 2009-05 to 2011-09, 11 children with single ventricle complicated with TAPVC were treated in our department. The age was 30.1 卤21.4months, and the body weight was 11.0 卤3.2kg.In case 2, modified B-T shunt was performed in 2 cases, unilateral or bilateral bidirectional cavopulmonary shunt was performed in one or both sides of 9 cases in 1 case, and one stage modified Fontan was performed in 7 cases (10 cases).In case 1, 6 cases were treated with TAPVC at the same time.Results: in 6 cases, 10 cases died during perioperative period. The causes of death were central nervous system infection and multiple organ failure.The surviving children were followed up for 1 to 29 months and died in case 4. The oxygen saturation of the remaining children was improved and no residual pulmonary vein obstruction was found. Case 5 underwent secondary modified Fontan and was discharged successfully.Conclusion: there is still a high early mortality rate in children with single ventricle complicated with TAPVC. It is the key to improve the curative effect of operation to diagnose TAPVC clearly before operation and to make reasonable individualized treatment plan.
【作者单位】：中国医学科学院
【分类号】：R726.5

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