中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2014年
3期
310-313
,共4页
闫芳%张会军%王军%孙丽颖%吕瑛%李小兵%董彦博
閆芳%張會軍%王軍%孫麗穎%呂瑛%李小兵%董彥博
염방%장회군%왕군%손려영%려영%리소병%동언박
法洛四联症%一期手术%矫治经验
法洛四聯癥%一期手術%矯治經驗
법락사련증%일기수술%교치경험
Fallot%One stage operation%Repair experience
目的 总结左心室较小的法洛四联症患儿一期矫治手术经验.方法 2008年3月至2012年6月,一期手术矫治左心室较小的法洛四联症患儿38例,男18例,女20例；手术年龄5～18月,平均年龄(9.37±2.45)个月,体质量6.6～10.4 kg,平均体质量(8.33±1.72) kg.所有患儿口唇发绀,均采用胸骨正中切口一期手术通过扩大室间隔缺损来根治左心室较小的法洛四联症.结果 全组病例均存活,随访6个月～3年,恢复良好.手术前、出院时、术后3个月左心房前后径(14.07±0.79)、(14.37±0.68)、(16.01 ±0.72) mm、右心房横径(18.23±1.07)、(18.74±0.96)、(19.28±0.71)mm、主肺动脉内径(7.98±0.92)、(8.16±0.54)、(9.92±0.81) mm、左心室舒张末期内径(19.27±1.15)、(21.06±1.75)、(23.41±1.18) mm、左心室短轴缩短率(35.57±1.45)、(32.61±2.15)、(34.29±2.12)％、收缩期主肺动脉血流速度(450.0±98.36)、(150.00±9.22)、(148.00±7.92)cm/s比较,差异均有统计学意义(F值分别为99.474、69.760、108.620、96.410、99.485、102.914;P均为0.000).结论 法洛四联症矫治术后心脏重构明显,既减轻了右心室的容量负荷又明显改善了左心室的功能.
目的 總結左心室較小的法洛四聯癥患兒一期矯治手術經驗.方法 2008年3月至2012年6月,一期手術矯治左心室較小的法洛四聯癥患兒38例,男18例,女20例；手術年齡5～18月,平均年齡(9.37±2.45)箇月,體質量6.6～10.4 kg,平均體質量(8.33±1.72) kg.所有患兒口脣髮紺,均採用胸骨正中切口一期手術通過擴大室間隔缺損來根治左心室較小的法洛四聯癥.結果 全組病例均存活,隨訪6箇月～3年,恢複良好.手術前、齣院時、術後3箇月左心房前後徑(14.07±0.79)、(14.37±0.68)、(16.01 ±0.72) mm、右心房橫徑(18.23±1.07)、(18.74±0.96)、(19.28±0.71)mm、主肺動脈內徑(7.98±0.92)、(8.16±0.54)、(9.92±0.81) mm、左心室舒張末期內徑(19.27±1.15)、(21.06±1.75)、(23.41±1.18) mm、左心室短軸縮短率(35.57±1.45)、(32.61±2.15)、(34.29±2.12)％、收縮期主肺動脈血流速度(450.0±98.36)、(150.00±9.22)、(148.00±7.92)cm/s比較,差異均有統計學意義(F值分彆為99.474、69.760、108.620、96.410、99.485、102.914;P均為0.000).結論 法洛四聯癥矯治術後心髒重構明顯,既減輕瞭右心室的容量負荷又明顯改善瞭左心室的功能.
목적 총결좌심실교소적법락사련증환인일기교치수술경험.방법 2008년3월지2012년6월,일기수술교치좌심실교소적법락사련증환인38례,남18례,녀20례；수술년령5～18월,평균년령(9.37±2.45)개월,체질량6.6～10.4 kg,평균체질량(8.33±1.72) kg.소유환인구진발감,균채용흉골정중절구일기수술통과확대실간격결손래근치좌심실교소적법락사련증.결과 전조병례균존활,수방6개월～3년,회복량호.수술전、출원시、술후3개월좌심방전후경(14.07±0.79)、(14.37±0.68)、(16.01 ±0.72) mm、우심방횡경(18.23±1.07)、(18.74±0.96)、(19.28±0.71)mm、주폐동맥내경(7.98±0.92)、(8.16±0.54)、(9.92±0.81) mm、좌심실서장말기내경(19.27±1.15)、(21.06±1.75)、(23.41±1.18) mm、좌심실단축축단솔(35.57±1.45)、(32.61±2.15)、(34.29±2.12)％、수축기주폐동맥혈류속도(450.0±98.36)、(150.00±9.22)、(148.00±7.92)cm/s비교,차이균유통계학의의(F치분별위99.474、69.760、108.620、96.410、99.485、102.914;P균위0.000).결론 법락사련증교치술후심장중구명현,기감경료우심실적용량부하우명현개선료좌심실적공능.
Objective To share the clinical experience of tetralogy of stage Ⅰ Fallot children with little left ventricle.Methods Thirty-eight cases with stage Ⅰ Fallot with little left ventricle from March 2008 to Jun 2012 were selected as our subjects.Of them,18 were boys and 20 were girls.The age of the cases ranged from 5 to 18 months and average was (9.37 ±2.45) months.The weight ranged from 6.6 to 10.4 kg,and average was (8.33 ± 1.72) kg.All cases showed cyanosis of oral lip.They all were performed tetralogy by the breast bone median incision and then expanding interventricular septal defect.Results All cases survived.Following-up 6 -18 months showed that all cases got good recovery.Left arterial diameter at before the operation,discharge,3 months after surgery were (14.07 ± 0.79) mm,(14.37 ± 0.68) mm,(16.01 ± 0.72) mm respectively and transverse diameter of right atrium were (18.23 ± 1.07) mm,(18.74 ± 0.96) mm,(19.28 ± 0.71) mm respectively.The differences were significant (F =99.474,69.760,P =0.000).Main pulmonary artery diameter at before the operation,discharge,3 months after surgery were (7.98 ±0.92) mm,(8.16 ±0.54) mm and (9.92 ± 0.81) mm,and left ventricular end diastolic diameter were (19.27 ± 1.15) mm,(21.06 ± 1.75) mm,(23.41 ± 1.18) mm.Meanwhile,left ventricular fractional shortening rate were (35.57 ± 1.45)％,(32.61 ± 2.15) ％,(34.29 ± 2.12) ％,and main pulmonary artery systolic flow velocity were (450 ± 98.36) cm/s,(150.0 ± 9.22) cm/s,(148.0 ± 7.92) cm/s.All differences were statistically significant (F =108.620,96.410,99.485,102.914;P =0.000).Conclusion Tetralogy on Fallot children with little left ventricle can lead to cardiac remodeling,which reduce the load of right ventricle and improve left ventricular function.
