CAJ | 학술논문

目的总结76例完全性房室隔缺损的手术治疗情况,为今后掌握最佳手术时机及手术方法提供参考.方法根据Rastelli分型:A型57例,B型6例,C型13例.采用“二片”修补法畸形矫治65例,室间隔缺损直接缝合法7例,格林(Glenn)分流术4例.结果手术死亡2例,1例为合并右室双出口及完全性肺静脉异位引流,术后死于低心排综合征,另1例为并发严重肺动脉高压,术后出现低氧血症,呼吸衰竭而死亡.余患者随访1 ～10年,3例患者发现二尖瓣中度返流,9例二尖瓣轻度返流.结论对于已确诊的完全性房室隔缺损患者,应尽早手术治疗,以防疾病的进一步恶化,同时纠正合并畸形.
목적 총결76례완전성방실격결손적수술치료정황,위금후장악최가수술시궤급수술방법제공삼고.방법 근거Rastelli분형:A형57례,B형6례,C형13례.채용“이편”수보법기형교치65례,실간격결손직접봉합법7례,격림(Glenn)분류술4례.결과 수술사망2례,1례위합병우실쌍출구급완전성폐정맥이위인류,술후사우저심배종합정,령1례위병발엄중폐동맥고압,술후출현저양혈증,호흡쇠갈이사망.여환자수방1 ～10년,3례환자발현이첨판중도반류,9례이첨판경도반류.결론 대우이학진적완전성방실격결손환자,응진조수술치료,이방질병적진일보악화,동시규정합병기형.
Objective To achieve the best chance and optimize the method of operation,the clinical outcomes of 76 cases with complete atrioventricular septal defect (CAVSD) were summarized.Methods According to the Rastelli classification,there were 57 cases of type A,6 type B,and 13 type C.The repaired procedures included the two-patch technique for atrioventricular septal defect (65 cases),direct closure of ventricular septal defect (7 cases),and the Glenn bidirection shunt (4 cases).Results Two patients died.Of them,one was concomitant with double outlet right ventricle (DORV) and total anomalous pulmonary venous connection (TAPVC),died of low cardiac output syndrome; another was complicated with severe pulmonary hypertension,and the death reason was hypoxaemia and respiratory function failure.The survived patients were followed up,and the follow-up period was varied from one to ten years,mitral valve regurgitation was found in 12 cases,3 were middle and 9 were mild.Conclusions In order to prevent deteriorated condition of these patients and improve the survival rate,CAVSD should be operated as soon as the diagnosis is certain,and the co-exist malformation also should be corrected.