CAJ | 학술논문

目的探讨部分型肺静脉异位引流手术治疗的效果,提高术前确诊率.方法回顾性分析北京安贞医院1997至2006年收治的38例部分型肺静脉异位引流患儿的病例资料.38例患儿术前均行超声检查,部分结合行右心导管造影或高螺旋CT检查,结合术中探查确诊;本组患儿均行手术治疗,补片修补扩大后的房间隔缺损将异位引流的肺静脉隔入左心房或者将垂直静脉与左心房直接吻合或用同种血管连接,矫正肺静脉异位引流的同时纠正合并畸形.结果 1例患儿死于术后严重低心排;2例术后分别合并Ⅱ度房室传导阻滞和肺动脉高压危象,治疗后康复;术后随诊3个月～7年,37例患儿生活质量良好.结论部分型肺静脉异位引流较易漏诊,超声应重视对肺静脉开口位置及血流的观察,必要时结合食管超声或造影检查,CT及核磁共振检查对部分型肺静脉异位引流的诊断有更高的确诊率;部分型肺静脉异位引流手术效果满意.
목적 탐토부분형폐정맥이위인류수술치료적효과,제고술전학진솔.방법 회고성분석북경안정의원1997지2006년수치적38례부분형폐정맥이위인류환인적병례자료.38례환인술전균행초성검사,부분결합행우심도관조영혹고라선CT검사,결합술중탐사학진;본조환인균행수술치료,보편수보확대후적방간격결손장이위인류적폐정맥격입좌심방혹자장수직정맥여좌심방직접문합혹용동충혈관련접,교정폐정맥이위인류적동시규정합병기형.결과 1례환인사우술후엄중저심배;2례술후분별합병Ⅱ도방실전도조체화폐동맥고압위상,치료후강복;술후수진3개월～7년,37례환인생활질량량호.결론 부분형폐정맥이위인류교역루진,초성응중시대폐정맥개구위치급혈류적관찰,필요시결합식관초성혹조영검사,CT급핵자공진검사대부분형폐정맥이위인류적진단유경고적학진솔;부분형폐정맥이위인류수술효과만의.
Objective To explore the diagnosis and treatment of partial anomalous pulmonary venous connection(PAPVC).Methods The clinical data of 38 pediatric patients with PAPVC were retrospectively reviewed.All received uhrasonography and part of them received angiography or 64-detector spiral computed tomography.Then the enlarged atrial septal was repaired with patch to separate the pulmonary vein dystopia to left atrium or the vertical vein was anastomosed to left atrium directly or by homograft vessel.The complicating abnormities were corrected.Follow-up was conducted for 3 months to 7years.Results One case died from severe low cardiac output after operation.Two cases were complicated postoperatively with Ⅱ°atrial ventricular block and one with pulmonary hypertensive crisis,and all were cured after treatment.And the other patients recovered after surgery.Follow-up showed that the quality of their postoperative life was good and no relapse to obstruction of pulmonary venous was reported. Conclusion overviewed carefully during uhrasonographic examination.Transesophageal echoeardiography and contrast examination may help.CT and MRI elevate the final diagnosis rate of PAPVC.The result of operation on PAPVC is good.