中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2012年
24期
17-19
,共3页
陈国庆%孙婷%乔衍礼%倪良春%郑善光%王为新
陳國慶%孫婷%喬衍禮%倪良春%鄭善光%王為新
진국경%손정%교연례%예량춘%정선광%왕위신
心脏缺损,先天性%儿童%双向Glenn术
心髒缺損,先天性%兒童%雙嚮Glenn術
심장결손,선천성%인동%쌍향Glenn술
Heart defects,congenital%Child%Bidirectional Glenn shunt
目的 探讨非体外循环双向Glenn术治疗小儿复杂先天性心脏病的临床应用效果.方法 选取采用非体外循环双向Glenn术治疗复杂先天性心脏病患儿46例(非体外循环组),同期采用体外循环双向Glenn术治疗复杂先天性心脏病患儿40例(体外循环组),比较两组的临床疗效.结果 两组均无死亡病例.非体外循环组术后肺动脉压显著低于体外循环组[(16.7±1.2)mm Hg(1 mm Hg=0.133 kPa)比(18.9±1.0) mm Hg],差异有统计学意义(t=4.686,P=0.026);非体外循环组术后呼吸机辅助呼吸时间显著短于体外循环组[(12.2±2.7)h比(19.2±2.8)h],差异有统计学意义(t=2.972,P=0.041)；两组术后血氧饱和度、乳糜胸发生率比较差异无统计学意义(P＞0.05).所有患儿术后紫绀、活动后气促等症状、体征明显减轻.结论 非体外循环双向Glenn术疗效显著、安全可靠,是治疗复杂先天性心脏病有效的手术方法.
目的 探討非體外循環雙嚮Glenn術治療小兒複雜先天性心髒病的臨床應用效果.方法 選取採用非體外循環雙嚮Glenn術治療複雜先天性心髒病患兒46例(非體外循環組),同期採用體外循環雙嚮Glenn術治療複雜先天性心髒病患兒40例(體外循環組),比較兩組的臨床療效.結果 兩組均無死亡病例.非體外循環組術後肺動脈壓顯著低于體外循環組[(16.7±1.2)mm Hg(1 mm Hg=0.133 kPa)比(18.9±1.0) mm Hg],差異有統計學意義(t=4.686,P=0.026);非體外循環組術後呼吸機輔助呼吸時間顯著短于體外循環組[(12.2±2.7)h比(19.2±2.8)h],差異有統計學意義(t=2.972,P=0.041)；兩組術後血氧飽和度、乳糜胸髮生率比較差異無統計學意義(P＞0.05).所有患兒術後紫紺、活動後氣促等癥狀、體徵明顯減輕.結論 非體外循環雙嚮Glenn術療效顯著、安全可靠,是治療複雜先天性心髒病有效的手術方法.
목적 탐토비체외순배쌍향Glenn술치료소인복잡선천성심장병적림상응용효과.방법 선취채용비체외순배쌍향Glenn술치료복잡선천성심장병환인46례(비체외순배조),동기채용체외순배쌍향Glenn술치료복잡선천성심장병환인40례(체외순배조),비교량조적림상료효.결과 량조균무사망병례.비체외순배조술후폐동맥압현저저우체외순배조[(16.7±1.2)mm Hg(1 mm Hg=0.133 kPa)비(18.9±1.0) mm Hg],차이유통계학의의(t=4.686,P=0.026);비체외순배조술후호흡궤보조호흡시간현저단우체외순배조[(12.2±2.7)h비(19.2±2.8)h],차이유통계학의의(t=2.972,P=0.041)；량조술후혈양포화도、유미흉발생솔비교차이무통계학의의(P＞0.05).소유환인술후자감、활동후기촉등증상、체정명현감경.결론 비체외순배쌍향Glenn술료효현저、안전가고,시치료복잡선천성심장병유효적수술방법.
Objective To evaluate the clinical application of bidirectional Glenn shunt without extracorporeal circulation (ECC) on treatment of children with complicated congenital heart disease (CHD).Methods Forty-six patients with complicated CHD (without ECC group) underwent bidirectional Glenn shunt without ECC,and 40 patients with complicated CHD (with ECC group) underwent bidirectional Glenn shunt with ECC.The therapeutic effect was compared between two groups.Results There was no operative mortality in two groups.The pulmonary artery pressure in without ECC group was significantly lower than that in with ECC group [( 16.7 ± 1.2) mm Hg ( 1 mm Hg =0.133 kPa) vs.( 18.9 ± 1.0) mm Hg,t =4.686,P=0.026 ].Duration of respirator assistance after operation in without ECC group was significantly lower than that in with ECC group [ ( 12.2 ± 2.7) h vs.( 19.2 ± 2.8) h,t =2.972,P =0.041 ].There was no significant difference in saturation of blood oxygen and the rate of chylothorax after operation between two groups (P＞0.05).The symptoms and signs including cyanosis and breath were markedly alleviative in all patients.Conclusion Bidirectional Glenn shunt without ECC is an effective and safe method for complicated CHD.
