CAJ | 학술논문

目的评价先天性心脏病(先心病)合并体静脉异位引流的外科手术治疗效果.方法 2009年4月至2012年8月,8例先天性心脏病合并体静脉异位引流患儿接受外科治疗,年龄7个月～6.5岁,体质量7.0～15.5 kg.合并完全型房室间隔缺损2例,冠状静脉窦型房间隔缺损1例,室间隔缺损1例,室间隔缺损、功能单心房1例,右心室双出口、肺动脉瓣狭窄1例,单心房、部分型房室间隔缺损、部分型肺静脉异位引流1例,单心房、单心室、肺动脉狭窄1例.手术采用结扎左上腔静脉、左上腔静脉移位合并心房间隔重建、左上腔静脉连接到右心房、腔静脉一肺动脉吻合、部分性无顶冠状窦的修补.结果全组无死亡.2例为先心病术后血氧饱和度低,故发现体静脉异位引流,行二次手术根治.出院前所有患儿经彩色多普勒超声心动图检查显示左上腔静脉回流和肺静脉回流均通畅.随访0.5～4.0年,所有患儿活动量增加、心功能改善.结论对体静脉异位引流须根据不同畸形采用不同的处理方法,其原则为将异位引流的静脉血引入体静脉系统或引流入肺动脉系统,使其得到氧合.
목적 평개선천성심장병(선심병)합병체정맥이위인류적외과수술치료효과.방법 2009년4월지2012년8월,8례선천성심장병합병체정맥이위인류환인접수외과치료,년령7개월～6.5세,체질량7.0～15.5 kg.합병완전형방실간격결손2례,관상정맥두형방간격결손1례,실간격결손1례,실간격결손、공능단심방1례,우심실쌍출구、폐동맥판협착1례,단심방、부분형방실간격결손、부분형폐정맥이위인류1례,단심방、단심실、폐동맥협착1례.수술채용결찰좌상강정맥、좌상강정맥이위합병심방간격중건、좌상강정맥련접도우심방、강정맥일폐동맥문합、부분성무정관상두적수보.결과 전조무사망.2례위선심병술후혈양포화도저,고발현체정맥이위인류,행이차수술근치.출원전소유환인경채색다보륵초성심동도검사현시좌상강정맥회류화폐정맥회류균통창.수방0.5～4.0년,소유환인활동량증가、심공능개선.결론 대체정맥이위인류수근거불동기형채용불동적처리방법,기원칙위장이위인류적정맥혈인입체정맥계통혹인류입폐동맥계통,사기득도양합.
Objective To evaluate the surgical approach of defect associated with anomalous systemic venous drainage (ASVD) in infant and young children.Methods From April 2009 to August 2012,8 cases of anomalous systemic venous drainage were corrected by primary repair.Their age ranged from 7 months to 6.5 years and body weight from 7.0 to 15.5 kg.Diseases complicated with ASVD included,coronary sinus atrial septal defect 1 case,ventricular septal defect 1 case,ventricu lar septal defect with single atrium 1 case,double outlet of right ventricle(DORV) 1 case,complete atrioventricular septal defect(CAVSD) 2 case,partial atrioventricular septal defect (PAVSD) with arpartial abnormal pulmonary venous drainage (PAPVD) 1 case,and single atrium with single ventricle 1 case.The ways for surgical treatment of distal abnormalities of left superior vena cava(LSVC) were reconstruction of atrial septum,translocation of LSVC and reconstruction of atrial septum,right atrium and LSVC anastomosis,cavopulmonary anastomosis and repair of partidly unroofed coronary sinus.Results No patient died.2 cases underwent secondary surgery.The echocardiography showed no obstruction of the blood flow in LSVC and pulmonary veins.The results of follow-up were satisfactory,from 6 monthes to 4 years.Conclusion Key for success of surgical approach of anomalous systemic venous drainage is precise evaluation of different kinds of LSVC and different surgical approaches.