CAJ | 학술논문

目的探讨非心肺转流术(CPB)双向腔肺分流术(Glenn术)治疗先天性心脏病的临床疗效.方法回顾性分析2005年8月至2011年8月44例行双向腔肺分流术患者的临床资料,其中采用非CPB患者23例(非CPB组),CPB患者21例(CPB组),对比分析两组患者呼吸机辅助呼吸时间、胸腔引流量、血液制品使用量、术后住院时间和出院时脉搏血氧饱和度(SpO2).结果 44例患者均治愈出院,无死亡病例.非CPB组呼吸机辅助呼吸时间、胸腔引流量和血液制品使用量分别为(4.5±1.3)h、(4.6±1.4) ml/kg和(221.8±97.6) ml,均明显少于CPB组的(6.7±1.5)h、(7.7±3.1)ml/kg和(423.4±149.7) ml,差异有统计学意义(P＜0.05),非CPB组术后住院时间和出院时SpO2分别为(7.4±2.3)d和0.91±0.05,而CPB组为(7.8±1.9)d和0.88±0.39,两组比较差异无统计学意义(P＞0.05).结论在非CPB下施行双向腔肺分流术是一种安全、可行的手术,值得临床推广.
목적 탐토비심폐전류술(CPB)쌍향강폐분류술(Glenn술)치료선천성심장병적림상료효.방법 회고성분석2005년8월지2011년8월44례행쌍향강폐분류술환자적림상자료,기중채용비CPB환자23례(비CPB조),CPB환자21례(CPB조),대비분석량조환자호흡궤보조호흡시간、흉강인류량、혈액제품사용량、술후주원시간화출원시맥박혈양포화도(SpO2).결과 44례환자균치유출원,무사망병례.비CPB조호흡궤보조호흡시간、흉강인류량화혈액제품사용량분별위(4.5±1.3)h、(4.6±1.4) ml/kg화(221.8±97.6) ml,균명현소우CPB조적(6.7±1.5)h、(7.7±3.1)ml/kg화(423.4±149.7) ml,차이유통계학의의(P＜0.05),비CPB조술후주원시간화출원시SpO2분별위(7.4±2.3)d화0.91±0.05,이CPB조위(7.8±1.9)d화0.88±0.39,량조비교차이무통계학의의(P＞0.05).결론 재비CPB하시행쌍향강폐분류술시일충안전、가행적수술,치득림상추엄.
Objective To investigate the clinical efficacy of bidirectional Glenn shunt with noncardiopulmonary bypass (CPB) for treating congenital heart disease.Methods The clinical data of forty-four patients receiving bidirectional Glenn shunt from August 2005 to August 2011 were analyzed retrospectively,twenty-three cases of which were treated by bidirectional Glenn shunt with non-CPB (non-CPB group) and twenty-one with CPB (CPB group).The duration of ventilator-assisted breathing,chest drainage volume,amount of blood product usage,postoperative hospital stay and pulse oxygen saturation (SpO2) before leaving the hospital were compared and analyzed between two groups.Results Forty-four patients were all cured.The duration of ventilator-assisted breathing,chest drainage volume and the amount of blood product usage of non-CPB group were less than those of CPB group [ (4.5 ± 1.3 ) h vs.(6.7 ± 1.5 ) h,(4.6 ± 1.4 ) ml/kg vs.(7.7 ± 3.1 ) ml/kg,( 221.8 ± 97.6 ) ml vs.( 423.4 ± 149.7 ) ml,P ＜ 0.05 ].There was no significant difference of the postoperative hospital stay and SpO2 before leaving the hospital between non-CPB group and CPB group[ (7.4 ± 2.3 ) d vs.(7.8 ± 1.9) d,0.91 ± 0.05 vs.0.88 ± 0.39,P ＞ 0.05 ].Conclusion Bidirectional Glenn shunt with non-CPB is a safe and feasible surgical approach,which is worthy of promotion.