中华小儿外科杂志
中華小兒外科雜誌
중화소인외과잡지
CHINESE JOURNAL OF PEDIATRIC SURGERY
2008年
2期
70-73
,共4页
陈纲%贾兵%陈张根%李炘%叶明%惠慰
陳綱%賈兵%陳張根%李炘%葉明%惠慰
진강%가병%진장근%리흔%협명%혜위
心脏病,先天性%肺动脉%心脏外科手术
心髒病,先天性%肺動脈%心髒外科手術
심장병,선천성%폐동맥%심장외과수술
Heart diseases,congenital%Pulmonary artery%Cardiac surgical procedures
目的 探讨肺动脉环缩术在儿童复杂先天性心脏病中的应用经验,并对手术效果进行评价.方法 回顾性分析2002年1月～2007年3月进行的32例肺动脉环缩术.男22例,女10例,手术年龄平均9.2个月,体重平均6.1 kg.肺动脉环缩后肺动脉周径平均(28.0±4.1)mm,术后估测环缩近远端压差(43.7±9.0)mmHg.结果 围术期死亡1例,2例患儿再次调整环缩.4例患儿出现围术期并发症.31例患儿随访1个月～5年,22例患儿进行Ⅱ期手术.结论 肺动脉环缩术可限制肺血过多,锻炼左心室,为Ⅱ期施行双心室矫治及双向腔肺分流术赢得时机.
目的 探討肺動脈環縮術在兒童複雜先天性心髒病中的應用經驗,併對手術效果進行評價.方法 迴顧性分析2002年1月～2007年3月進行的32例肺動脈環縮術.男22例,女10例,手術年齡平均9.2箇月,體重平均6.1 kg.肺動脈環縮後肺動脈週徑平均(28.0±4.1)mm,術後估測環縮近遠耑壓差(43.7±9.0)mmHg.結果 圍術期死亡1例,2例患兒再次調整環縮.4例患兒齣現圍術期併髮癥.31例患兒隨訪1箇月～5年,22例患兒進行Ⅱ期手術.結論 肺動脈環縮術可限製肺血過多,鍛煉左心室,為Ⅱ期施行雙心室矯治及雙嚮腔肺分流術贏得時機.
목적 탐토폐동맥배축술재인동복잡선천성심장병중적응용경험,병대수술효과진행평개.방법 회고성분석2002년1월～2007년3월진행적32례폐동맥배축술.남22례,녀10례,수술년령평균9.2개월,체중평균6.1 kg.폐동맥배축후폐동맥주경평균(28.0±4.1)mm,술후고측배축근원단압차(43.7±9.0)mmHg.결과 위술기사망1례,2례환인재차조정배축.4례환인출현위술기병발증.31례환인수방1개월～5년,22례환인진행Ⅱ기수술.결론 폐동맥배축술가한제폐혈과다,단련좌심실,위Ⅱ기시행쌍심실교치급쌍향강폐분류술영득시궤.
Objective To discuss the application of pulmonary artery banding(PAB)in the treatment of complex congenital heart defect in children and evaluate the result of the procedure.Methods Thirty-two children with complex congenital heart defects underwent pulmonary artery banding procedure in our center from Jan 2002 to Mar 2007.There are 22 boys and 10 girls,the mean age was(9.2±18.0)months,the mean body weight was(6.1±3.9)kg,the mean saturation was(89.5±6.3)%.The diameter of main pulmonary artery was(16.3±3.0)mm by echocardiography and mean pulmonary artery pressure was(44.5±7.6)mmHg before operation.The mean postoperative circumstance of main pulmonary artery was(28.0±4.1)mm,and the mean pressure gradient over the banding was(43.7±9.0)mmHg.Results There was one postoperative death because of infection,and 2 cases underwent rebanding procedure.The mean ventilation time was(44.3±164.9)hrs and the mean ICU stay time was(4.1±7.1)d.The postoperative saturation was(82.7±9.1)%.The morbidity was 4/31.Thirty-one cases were followed up from 1 month to 5 years.Twenty-two cases un derwent the 2nd stage procedure while the banding belts were taken down and 11 cases underwent the pulmonary artery angioplasty.Conclusions The pulmonaty artery banding procedure can limit the pulmonary blood flow to protect the pulmonary vessels and retrain the left ventricle in d-TGA cases.It is a safe palliative procedure with satisfying operative results,followed by biventricular repair or univentricular repair as further surgical intervention.
