CAJ | 학술논문

目的总结不同方法进行解剖矫治右心室双出口(DORV)经验.方法 2007年5月至2012年5月,收治135例DORV患儿,男79例,女56例；年龄为出生后25天～12岁；体质量3.5 ～ 30.0 kg.根据室间隔缺损的位置选择不同手术方法:89例主动脉瓣下缺损及33例双瓣下缺损患儿均行右心室双出口解剖矫治术；8例肺动脉瓣下缺损(Taussig-Bing畸形)患儿中5例行Rastelli手术,3例行动脉调转术±室间隔修补术；5例远离大动脉缺损中3例行Rastelli手术,2例行动脉调转术±室间隔修补术.结果住院死亡5例,占3.70％；分别为1例肺动脉瓣下缺损行动脉调转术±室间隔修补术,1例双瓣下缺损,2例主动脉瓣下缺损(均合并肺动脉瓣狭窄)均行合右室双出口解剖矫治术,1例远离大动脉缺损行Rastelli手术者.结论右室双出口病理解剖比较复杂,须根据不同的解剖条件选择不同的手术方法才能减少手术死亡.
목적 총결불동방법진행해부교치우심실쌍출구(DORV)경험.방법 2007년5월지2012년5월,수치135례DORV환인,남79례,녀56례；년령위출생후25천～12세；체질량3.5 ～ 30.0 kg.근거실간격결손적위치선택불동수술방법:89례주동맥판하결손급33례쌍판하결손환인균행우심실쌍출구해부교치술；8례폐동맥판하결손(Taussig-Bing기형)환인중5례행Rastelli수술,3례행동맥조전술±실간격수보술；5례원리대동맥결손중3례행Rastelli수술,2례행동맥조전술±실간격수보술.결과 주원사망5례,점3.70％；분별위1례폐동맥판하결손행동맥조전술±실간격수보술,1례쌍판하결손,2례주동맥판하결손(균합병폐동맥판협착)균행합우실쌍출구해부교치술,1례원리대동맥결손행Rastelli수술자.결론 우실쌍출구병리해부비교복잡,수근거불동적해부조건선택불동적수술방법재능감소수술사망.
Objective To summarize the experiences and results of completed surgical treatment for double outlet of right ventricle in 135 cases.Methods From May 2007 to May 2012,135 cases with double outlet of the right ventricle,males are 79 cases,female are 56 cases,age from 25 days to 12 years,weigh is 3.5-30.0 kg,underwent surgical procedure.There were 89 cases subaortic ventricular septal defect,33 cases doubly committed ventricular septal defect,repaired VSD with introventricular tunnel and relive right ventricle outflow tract directly with pericardial patch.There are 8 cases subpulmonary (Taussing-Bing)VSD,5 received Rastelli procedure,3 received arterial switch procedure and repaird VSD.There are 5 cases noncommited VSD,3 received Rastelli procedure,2 received arterial switch procedure and repaired VSD.Results Four cases died in the early postoperative period,with a mortality of 3.70％.1 case with subpulmonary VSD was performed arterial switch procedure and repaired VSD.1 case with noncommited VSD,2 cases with subaortic VSD(with pulmonary stenosis) were performed repaired VSD with introventricular tunnel and relive right ventricle outflow tract directly with pericardial patch.1 case with noncommited VSD was performed Rastelli procedure.Conclusion The anatomic type,especially the position of ventricular septal defect,correlates with surgical strategy significantly.