Hybrid手术治疗法洛四联症合并巨大体肺侧枝循环的临床应用价值
发布时间：2018-11-22 06:02
【摘要】：目的：评价Hybrid手术治疗法洛四联症(TOF)合并巨大体肺侧枝循环(MAPCAs)的临床效果及其临床应用价值。 方法：回顾分析2009年12月至2013年8月期间我院11例复杂型法洛四联症合并巨大体肺侧枝循环的病例,均采用先行介入封堵,后行根治性手术的联合治疗。 结果：共发现体肺侧支动脉18支,侧支直径2～7mm,平均4.3±1.5mm。对其中15支巨大体肺侧支进行了成功封堵,共用弹簧栓43枚。对于其中1支远端狭窄、2支细小("f2mm)的侧支血管不予封堵处理。介入封堵过程顺利,仅1例患者出现急性缺氧发作,急诊开胸行外科根治手术,其余10例均常规开胸手术。 手术过程顺利。升主动脉阻断时间(77.33士20.58)m in,体外循环时间(128.66±30.55)min,呼吸机辅助时间2-4天,ICU时间3-5天。1例术后当天行剖胸探查止血术；2例出现胸腔积液；11例均未出现肺水肿、灌注肺、低心排等并发症,无1例行补救性封堵术。术前紫绀的患者术后均明显减轻,缺氧症状明显改善,11例患者均于术后8-10天康复出院。 11例患者随访3-24个月,复查心脏CT提示侧枝封堵情况良好,其中1例患者心功能Ⅱ-Ⅲ级,其余患者心功能均在Ⅰ-Ⅱ级以上。 结论：Hybrid手术治疗法洛四联症合并巨大体肺侧枝循环的是安全稳定的,并具有出血少、损伤小、手术时间短、术后恢复快、并发症少等优点,临床应用价值巨大,Hybrid手术在先天性心脏病的治疗中有非常广阔的前景。
[Abstract]:Objective: to evaluate the clinical effect and clinical value of Hybrid in the treatment of tetralogy of Fallot (TOF) with giant pulmonary collateral circulation (MAPCAs). Methods: 11 cases of complex tetralogy of Fallot with giant pulmonary collateral circulation were retrospectively analyzed from December 2009 to August 2013. All patients were treated with interventional closure and radical operation. Results: a total of 18 pulmonary arteries were found, with a diameter of 2mm and an average of 4.3 卤1.5mm. Fifteen of them were successfully occluded with 43 spring plugs. For one of the distal stenosis, 2 small ("f2mm) collateral vessels were not occluded." The procedure of interventional closure was smooth, only one patient had acute anoxic attack, and the other 10 patients had routine thoracotomy. The operation went smoothly. The ascending aorta occlusion time (77.33 卤20.58) m in,) was (128.66 卤30.55) min, ventilator assisted time 2-4 days, ICU time 3-5 days. Pleural effusion was found in 2 cases, pulmonary edema, pulmonary perfusion and low cardiac output were not found in 11 cases. All patients with cyanosis were relieved and anoxic symptoms were improved. 11 patients were discharged from hospital from 8 to 10 days after operation. 11 patients were followed up for 3-24 months. The results of cardiac CT showed that the occlusion of collateral branches was good. One patient had cardiac function grade 鈪，
本文编号：2348303
[Abstract]:Objective: to evaluate the clinical effect and clinical value of Hybrid in the treatment of tetralogy of Fallot (TOF) with giant pulmonary collateral circulation (MAPCAs). Methods: 11 cases of complex tetralogy of Fallot with giant pulmonary collateral circulation were retrospectively analyzed from December 2009 to August 2013. All patients were treated with interventional closure and radical operation. Results: a total of 18 pulmonary arteries were found, with a diameter of 2mm and an average of 4.3 卤1.5mm. Fifteen of them were successfully occluded with 43 spring plugs. For one of the distal stenosis, 2 small ("f2mm) collateral vessels were not occluded." The procedure of interventional closure was smooth, only one patient had acute anoxic attack, and the other 10 patients had routine thoracotomy. The operation went smoothly. The ascending aorta occlusion time (77.33 卤20.58) m in,) was (128.66 卤30.55) min, ventilator assisted time 2-4 days, ICU time 3-5 days. Pleural effusion was found in 2 cases, pulmonary edema, pulmonary perfusion and low cardiac output were not found in 11 cases. All patients with cyanosis were relieved and anoxic symptoms were improved. 11 patients were discharged from hospital from 8 to 10 days after operation. 11 patients were followed up for 3-24 months. The results of cardiac CT showed that the occlusion of collateral branches was good. One patient had cardiac function grade 鈪，
本文编号：2348303
本文链接：https://www.wllwen.com/yixuelunwen/eklw/2348303.html
最近更新
教材专著
