干旱区生态环境知识资源中心(Arid): 婴幼儿室间隔完整的重度肺动脉瓣狭窄手术方案探讨

Arid

	婴幼儿室间隔完整的重度肺动脉瓣狭窄手术方案探讨
其他题名	A study on surgical approach of severe pulmonary valve stenosis with intact ventricular septum in infant and young children
	郑景浩; 刘锦纷; 苏肇伉; 丁文祥
来源期刊	中华胸心血管外科杂志
ISSN	1001-4497
出版年	2004
卷号	20 期号:6 页码:321-323
中文摘要	目的探讨婴幼儿室间隔完整的重度肺动脉瓣狭窄(PS)的手术指征和手术方法.方法 1999年6月至2004年3月,手术治疗室间隔完整的重度PS婴幼儿28例,年龄1.3～29.0个月,平均(11.32.0)个月.体重3.5～12.5 kg,平均(8.51.2) kg.据不同的手术方法分3组,第1组18例,三尖瓣Z值-1.0～-1.6,11例经肺动脉切口行肺动脉瓣膜交界切开,7例因瓣环小而采用自体心包补片进行右心室流出道至肺动脉的补片扩大;9例因术后低氧血症而加作体肺分流术.第2组7例,Z值-1.5～-4.8,行11/2心室修补,即右心室流出道至肺动脉的补片扩大+上腔静脉与右肺动脉的腔肺血管吻合(BDG);第3组3例,Z值-4.5～-6.7,行肺总动脉横断同时行BDG.结果手术死亡1例.余27例生存,术后血流动力学稳定,经皮氧饱和度平均0.95.随访3～24个月疗效满意.结论术前判断右心室发育不良的程度是手术成功的关键,手术方式除选择单心室和双心室修补外,11/2心室修补手术是一种安全、可靠、有效的手术方法.
英文摘要	Objective To review ihe surgical indications mid procedures in infunl and younger children who have severs pulmonary valve stenosis with inlael ventricular septum. Methods From June 1999 lo March 2004, 28 casra of severe pulmonary valve stenosis wilh intact ventricular septum were corrected surgically. The mean age was 11.3 months and the mean weight wus 8.5 kg. According to different surgical approaches, patients were divided into three groups. Group one, 18 patients with Z value was from -1.0 to -1.6 underwent bivenlricular repair, including 11 Irari.sarleruil pulmonary valvotomy and 7 Iransannular patching with aulologous pericardia! flake because of small valve annulus. Systemic-pulmonary shunting was added al ihe sume time in 9 of 18 chsch because of low oxygen saturation. Group two, 7 eases wilh the Z value was from - 1.5 to -4.8 underwent one and a half ventricle repair. The surgical approach was right ventricular transannular patching wilh bi-directional Glenn shunt between superior vena cuvh arid right pulmonary artery (BDG). In group three, 3 oases wilh the Z value was from - 4.5 to - 6.7 underwent BOG wilh transeclion of major pulmonary artery. Results One patient died with a postoperative mortality of 3.6%. The other 27 patients survived and the hemodynamics was stable and the mean of oxygen saturation was 0.95. The results of the follow-up were satisfactory from 3 months to 2 years. Conclusion The key of successful surgeiy is precise preoperative evaluation of degree of right ventricular hypotrophy. One and u half ventricle repair is a safe, reliable and effective way for the bivenlricular repais and single ventricular repair.
中文关键词	心脏缺损 ; 先天性 ; 心脏外科手术 ; 肺动脉瓣狭窄 ; 婴儿 ; 幼儿
英文关键词	Hearl defect congenital Cardiac surgical procedures Pulmonary valve stenosis Infant Children
语种	中文
国家	中国
收录类别	CSCD
WOS类目	SURGERY
WOS研究方向	Surgery
CSCD记录号	CSCD:1664715
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/205844
作者单位	上海第二医科大学附属新华医院,上海儿童医学中心心胸外科, 200127
推荐引用方式 GB/T 7714	郑景浩,刘锦纷,苏肇伉,等. 婴幼儿室间隔完整的重度肺动脉瓣狭窄手术方案探讨[J],2004,20(6):321-323.
APA	郑景浩,刘锦纷,苏肇伉,&丁文祥.(2004).婴幼儿室间隔完整的重度肺动脉瓣狭窄手术方案探讨.中华胸心血管外科杂志,20(6),321-323.
MLA	郑景浩,et al."婴幼儿室间隔完整的重度肺动脉瓣狭窄手术方案探讨".中华胸心血管外科杂志 20.6(2004):321-323.