干旱区生态环境知识资源中心(Arid): 婴儿完全型肺静脉畸形引流的手术治疗

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	婴儿完全型肺静脉畸形引流的手术治疗
其他题名	Correction of total anomalous pulmonary venous connection in infant less than one year old
	闫军; 陈庆良; 刘迎龙; 吴清玉; 许建屏; 李守军
来源期刊	中华医学杂志
ISSN	0376-2491
出版年	2002
卷号	82 期号:23 页码:1619-1621
中文摘要	目的探讨婴儿完全型肺静脉畸形引流早期手术治疗的意义。方法一岁以内完全型肺静脉畸形引流婴儿28例（男23例，女5例），手术矫治24例，平均月龄6.043.34，平均体重为5 74kg1.22kg;心上型10例(41.67),心内型11例(45.83).心下型1例(4.17),混合型2例(8.33).4例患儿术前准备过程中缺氧发作致循环呼吸衰竭死亡,未能实施矫治手术,其余患儿均在全麻,低温,体外循环下行完全型肺静脉畸形引流矫治术,其中急诊手术4例.结果术后早期(30d)死亡3例(12.5).心内型1例因术后出血时间较长,二次开胸探查较晚致循环衰竭死亡;心上型1例因术中吻合口渗血,心功能低下死亡;混合型1例因术毕左房压高,不复跳,最终循环衰竭死亡.4例急诊手术婴儿均存活,术后主要并发症为室上性心律失常(10例).结论婴儿完全型肺静脉畸形引流早期手术疗效满意.远期结果有待观察.左房,左室及房间隔缺损大小对手术效果无明显影响,必要时可行急诊手术.但心律失常发生率较高.
英文摘要	Objective To evcaluate the effects of early correction for total anomalous pulmonary venous connection (TAPVC) in infant under one. Methods Twenty- eight infants less than one year old with TAPVC were admitted and prepared to be treated surgically from July 1995 to August 2001 . Total correction was perfonned on 24 cases, 20 males and 4 famales, aged 6.04 3.34 months, with the mean body weight of 5.74 1.22 kg, of which 10 (41.67%) being of supracardic type, 11 (45.83%) being of intracardiac type, 1 (4.17%)being of infracardiac type, and 2 (8.33% ) being of mixed type. Four patients died of hypoxic attack during anteoperative preparation and failed to be operated upon. Results Three infants (12.5%) died within 30 days after operation. One case of inlracardiac type died of circulatory failure because of severe postoperative bleeding and late exploratory ihoracotomy . One case of supracardiac type died of cardiac sufficiency because of bleeding at anastomotic stoma during operation. One case of mixed type died of circulatory failure because of high pressure of left cardiac atrium. All of the 4 oases who underwent emergent operation survived . The most common complication was arrhythmia (41 . 67 % ) . Conclusion The early effect of early correction for TAPVC is satisfactory and its long-term effect is to be observed. A wide anastomosis between the posterior wall of the left atrium and common pulmonary vein is more important for the supracardic type. The diameters of left atrium, left ventricle and atrial septum defect have little effect on operative results. Arrhythmia after operation has no significant increase in supracardic type through. With rather high incidence rate of arrhythmia (5/8, 62.5%) , the combined left atrium incision and right atrium incision approach assures a sufficiendy large incision for the supracardiac type. However, this approach is statistically different in the incidence rate of arrhythmia only between supracardiac type and intracardiac type.
中文关键词	临床特点 ; 先天性心脏病 ; 婴儿 ; 完全型肺静脉畸形引流 ; 手术治疗
英文关键词	cardiovascular abnormalities infant procedares, operative
语种	中文
国家	中国
收录类别	CSCD
WOS类目	PEDIATRICS
WOS研究方向	Pediatrics
CSCD记录号	CSCD:1080899
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/203752
作者单位	中国医学科学院中国协和医科大学心血管病研究所阜外心血管病医院外科, 北京 100037, 中国
推荐引用方式 GB/T 7714	闫军,陈庆良,刘迎龙,等. 婴儿完全型肺静脉畸形引流的手术治疗[J],2002,82(23):1619-1621.
APA	闫军,陈庆良,刘迎龙,吴清玉,许建屏,&李守军.(2002).婴儿完全型肺静脉畸形引流的手术治疗.中华医学杂志,82(23),1619-1621.
MLA	闫军,et al."婴儿完全型肺静脉畸形引流的手术治疗".中华医学杂志 82.23(2002):1619-1621.