肺动脉闭锁合并室间隔缺损行肺动脉下拉重建右心室流出道近中期效果观察

发布时间：2019-02-12 22:54

【摘要】：目的观察肺动脉闭锁(PA)合并室间隔缺损(VSD)患儿行肺动脉下拉重建右心室流出道(RVOT)的近中期临床效果。方法选取54例PA合并VSD患儿,行肺动脉下拉重建RVOT手术;记录术后近中期(术后第1、6个月)患儿死亡及并发症情况,采用超声心动图观察肺动脉及其分支发育、三尖瓣及肺动脉反流面积、右心室面积变化分数(RVFAC)、三尖瓣环收缩期位移(TAPSE)、三尖瓣舒张早期峰值速度(Em)和舒张晚期峰值速度(Am)的比值(Em/Am)、右心室射血分数(RVEF)。结果 54例患儿术后第1个月内死亡6例、发生并发症11例,至第6个月未再发生死亡;患儿术后6个月肺动脉吻合口、左肺动脉开口、右肺动脉开口的直径和肺动脉、三尖瓣反流面积较术后第1个月增加(P均0.05),右心室功能相关指标与术后第1个月比较差异均无统计学意义(P均0.05)。结论 PA合并VSD患儿行肺动脉下拉重建RVOT后肺动脉吻合口及分支生长发育良好,术后近中期右心功能良好。
[Abstract]:Objective to observe the clinical effect of pulmonary artery atresia (PA) combined with ventricular septal defect (VSD) on pulmonary artery pull-down reconstruction of right ventricular outflow tract (RVOT). Methods 54 children with PA combined with VSD underwent pull-down reconstruction of RVOT. The mortality and complications were recorded in the middle and near postoperative period (1st and 6th month after operation). The development of pulmonary artery and its branches, the area of tricuspid valve and pulmonary artery regurgitation, and the change fraction of right ventricular area (RVFAC),) were observed by echocardiography. Ratio of tricuspid annular systolic displacement (TAPSE), tricuspid peak diastolic velocity (Em) to late diastolic peak velocity (Am) (Em/Am), right ventricular ejection fraction (RVEF).) Results there were 6 cases of death and 11 cases of complications in the first month after operation in 54 cases, and no further death occurred until the sixth month. The diameter and the area of tricuspid regurgitation of pulmonary artery anastomosis, left pulmonary artery opening, right pulmonary artery orifice and tricuspid regurgitation were increased 6 months after operation (all P 0.05). There was no significant difference in the right ventricular function between the first month and the first month after operation (P 0.05). Conclusion the pulmonary artery anastomosis and branch growth in children with PA combined with VSD after pulmonary pull-down reconstruction with RVOT are good, and the right heart function is good in the near and middle period after operation.
【作者单位】：河南省人民医院;
【基金】：河南省重点科技攻关计划项目(142102310083)
【分类号】：R725.4

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