中华胸心血管外科杂志
中華胸心血管外科雜誌
중화흉심혈관외과잡지
Chinese Journal of Thoracic and Cardiovascular Surgery
2014年
4期
206-209
,共4页
凌雁%郭保静%张陈%顾虹%戴辰晨%李强强%金梅%刘迎龙
凌雁%郭保靜%張陳%顧虹%戴辰晨%李彊彊%金梅%劉迎龍
릉안%곽보정%장진%고홍%대신신%리강강%금매%류영룡
单心室%双向Glenn手术%经皮介入治疗%体-肺侧支动脉%体静脉侧支%肺动脉球囊
單心室%雙嚮Glenn手術%經皮介入治療%體-肺側支動脈%體靜脈側支%肺動脈毬囊
단심실%쌍향Glenn수술%경피개입치료%체-폐측지동맥%체정맥측지%폐동맥구낭
Single ventricular%Bidirectional Glenn operation%Transcatheter intervention%Aortopulmonary collateral arteries%Systematic venous collaterals%Pulmonary balloon dilation
目的 探讨通过多种介入治疗方法,优化单心室生理双向Glenn手术后的治疗效果.方法 对22例单心室行双向腔静脉-肺动脉吻合术(双向Glenn手术)后患儿(者),选择性行经皮主-肺动脉侧支栓堵术、体静脉侧支栓堵术和/或肺动脉球囊扩张术等介入治疗.结果 22例接受介入治疗,男16例,女6例;年龄3.3~18.9岁,平均(9.3±4.2)岁;体质量13~54 kg,平均(29±13) kg.双向Glenn术后(3.1±3.8)年行介入治疗.栓堵主-肺动脉侧支12例,封堵奇静脉和/或半奇静脉11例,肺动脉球囊扩张6例;6例同时行两种介入治疗.介入治疗后9例行全腔静脉-肺动脉连接术,7例正等待Fontan手术,6例暂不宜行Fontan手术者仍随访中,临床状态稳定.结论 单心室行双向Glenn术后,通过个体化的经皮介入治疗方案,可优化治疗效果,为下一步治疗创造条件.
目的 探討通過多種介入治療方法,優化單心室生理雙嚮Glenn手術後的治療效果.方法 對22例單心室行雙嚮腔靜脈-肺動脈吻閤術(雙嚮Glenn手術)後患兒(者),選擇性行經皮主-肺動脈側支栓堵術、體靜脈側支栓堵術和/或肺動脈毬囊擴張術等介入治療.結果 22例接受介入治療,男16例,女6例;年齡3.3~18.9歲,平均(9.3±4.2)歲;體質量13~54 kg,平均(29±13) kg.雙嚮Glenn術後(3.1±3.8)年行介入治療.栓堵主-肺動脈側支12例,封堵奇靜脈和/或半奇靜脈11例,肺動脈毬囊擴張6例;6例同時行兩種介入治療.介入治療後9例行全腔靜脈-肺動脈連接術,7例正等待Fontan手術,6例暫不宜行Fontan手術者仍隨訪中,臨床狀態穩定.結論 單心室行雙嚮Glenn術後,通過箇體化的經皮介入治療方案,可優化治療效果,為下一步治療創造條件.
목적 탐토통과다충개입치료방법,우화단심실생리쌍향Glenn수술후적치료효과.방법 대22례단심실행쌍향강정맥-폐동맥문합술(쌍향Glenn수술)후환인(자),선택성행경피주-폐동맥측지전도술、체정맥측지전도술화/혹폐동맥구낭확장술등개입치료.결과 22례접수개입치료,남16례,녀6례;년령3.3~18.9세,평균(9.3±4.2)세;체질량13~54 kg,평균(29±13) kg.쌍향Glenn술후(3.1±3.8)년행개입치료.전도주-폐동맥측지12례,봉도기정맥화/혹반기정맥11례,폐동맥구낭확장6례;6례동시행량충개입치료.개입치료후9례행전강정맥-폐동맥련접술,7례정등대Fontan수술,6례잠불의행Fontan수술자잉수방중,림상상태은정.결론 단심실행쌍향Glenn술후,통과개체화적경피개입치료방안,가우화치료효과,위하일보치료창조조건.
Objective To summarize the preliminary results of transcatheter interventions in patients after bidirectional Glenn shunt(BGS) in single ventricular physiology.Methods In patients with single ventricular physiology after bidirectional Glenn shunt,transcatheter occlusion of aortopulmonary collateral arteries,closure of dilated azygous or /and hemiazygousveins,or/and balloon-dilation of pulmonary artery were selected to undertake,according to their clinical and catheterizational profiles.Results 22 patients aged(9.3 ±4.2) years(3.3-18.9 years),weighted(29 ±13) kg(13-54 kg),(3.1 ±3.8) years(1.0-12.5 years) after bidirectional Glenn shunt,received transcatheter interventions,including occlusion of aortopulmonary collateral arteries in 12 patients,closure of dilated azygous or/and hemiazygous veins in 11 cases,balloon-dilation of stenotic pulmonary arteries in 6 patients.Native pulmonary artery was dilated in 4 cases.The origin of the stenosed left pulmonary artery were dilated in another 2 patients.6 patients had received two kinds of interventions.After these transcatheter interventions,9 cases had received Fontan procedures uneventfully,7 cases were waiting for Fontan operation,and 6 cases presently not suitable for Fontan were closely followed-up with stable cardiac function and saturation of oxygen unchanged.Conclusion In patients with single ventricular physiology after bidirectional Glenn,individualized transcatheterly interventions can improve clinical results,and make condition for the Fontan operation.