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|本期目录/Table of Contents|

复杂紫绀型先天性心脏病并发体肺侧支的内外科镶嵌治疗

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2012年第4期
页码:
480-482
栏目:
临床研究
出版日期:
2012-08-25

文章信息/Info

Title:
Interventional and surgical hybrid therapy for patients with complex and cyanotic congenital heart defects with major pulmonary aorta collateral arteries
作者:
张刚成; 沈群山; 姚 艺; 陶 凉
(武汉亚洲心脏病医院心外科，湖北 武汉 430022)
Author(s):
ZHANG Gang-cheng;  SHEN Qun-shan;  YAO Yi;  TAO Liang
(Department of Cardiovascular Surgery, Wuhan Asia Heart Hospital, Wuhan 430022, Hubei, China)
关键词:
紫绀; 先天性心脏病; 体肺侧支; 镶嵌治疗
Keywords:
cyanotic;  congenital heart defects;  major pulmonary aorta collateral arteries;  hybrid therapy
分类号:
R541.1
DOI:
-
文献标识码:
A
摘要:
目的:总结并发体肺侧支的复杂紫绀型先天性心脏病内外科镶嵌治疗的临床经验，探讨其治疗意义、操作技术及安全性。方法： 回顾性分析41例并发体肺侧支的复杂紫绀型先心病患者，年龄1～28（15±10）岁，体质量（18±8）kg。均行螺旋CT检查确诊，38例术前封堵侧支血管，3例术前漏诊术后封堵侧支血管。全组均行外科一期矫治手术。结果： 全组治愈37例。死亡4例：1例死于肺部感染，3例死于顽固性心力衰竭。侧支血管直径2.5～9.4（5.3±2.1） mm。每位患者放置弹簧圈3～21（10±6）枚。3例术后因侧支血管再通而二次封堵。术后4例并发肺部感染，3例肺水肿，2例灌注肺。结论： 并发体肺侧支的复杂紫绀型先心病，在围手术期应当内外科联合处理侧支血管的问题。可采用经皮介入封堵法，有效、简单、安全，可行多支、多次封堵，有效减少并发症的发生，降低手术死亡率。
Abstract:
AIM:To summarize the clinical therapy experience of interventional and surgical hybrid therapy for patients with complex and cyanotic congenital heart defects with major pulmonary aorta collateral arteries and to explore its therapeutic significance, operating skills and safety. METHODS: To retrospectively analyze 41 patients with cyanotic CHD with pulmonary aorta collateral arteries. Ages of patients ranged from 1 to 28 years with a body weight of (18±8) kg. All subjects accepted CT diagnosis and 38 patients underwent interventional catheterization to close the collateral arteries. In three cases, collateral arteries were found after surgery and closed by catheterization. In all patients, one-stage repair was achieved. RESULTS: Thirty seven patients were cured, four patients died, one died from lung infection, and three patients died due to heart failure. The diameter of the collateral arteries ranged from 2.5 to 9.4 mm. Patients had 3 to 21 spring circles placed. Three patients had a second closure performed due to arterial recanalization. Fourteen patients had lung infection, three patients suffered from lung edema, and two patients had pleural fluid. CONCLUSION: Patients with complex and cyanotic congenital heart defects who have major pulmonary aorta collateral arteries can undergo interventional and surgical hybrid therapy to manage the collateral arteries. This method is effective, easy and safe, as well as being repeatable, which can reduce complications and decrease mortality.

参考文献/References

[1]郑 哲,李守军,胡盛寿,等.分期和“一站式”Hybrid手术治疗法洛四联症合并体肺动脉侧支血管形成的疗效比较[J].中国胸心血管外科临床杂志,2009,16(4):250-253.

[2]李晓锋,王 强,刘迎龙,等.肺血减少型复杂先天性心脏病合并的主要体肺动脉侧支分布规律的临床研究[J].中国分子心脏病学杂志,2009,9(2):104-106.

[3]De Giovanni JV.Timing,frequency,and results of catheter intervention following recruitment of major aortopulmonary collaterals in patients with pulmonary atresia and ventricular septal defect[J].J Interv Cardiol,2004,17(1):47-52.

[4]Ramsay JM,Macartney FJ,Haworth SG.Tetralogy of Fallotwith major aortopulmonary collateral arteries[J].Br Heart J,1985,53(2):167-172.

[5]周智恩,孙小圣,冯 君,等.肺血减少型先天性心脏病合并体肺侧枝的外科治疗[J].中国胸心血管外科临床杂志,2010,17(4):351.

[6]Suzuki K,Matsui M,Nakamura Y,et al.A case of coronary artery-pul-monary artery fistula in tetralogy of Fallot with pulmonary atresia andmajor aortopulmonary collateral arteries(MAPCA)[J].Nppon Kyobu Geka Gakkai Zasshi,1992,40(12):2252-2257.

[7]方敏华,朱洪玉,汪曾炜,等.法洛四联症合并大的主肺侧支动脉的手术矫治[J].中华外科杂志,2005,43(22):1437-1440.

[8]刘迎龙,沈向东,李守军,等.介入及手术联合矫治伴有体肺动脉侧枝的肺血减少型先天性心脏病[J].中华医学杂志,2006,86(4):228-231.

[9]刘迎龙,沈向东,李守军,等.肺动脉融合术治疗肺动脉闭锁合并大主肺侧支动脉[J].中华胸心血管外科杂志,2008,24(5):304-308.

备注/Memo

备注/Memo:
收稿日期：2011-11-27.作者简介：张刚成，副主任医师Email:zhanggangchen@medmail.com.cn
更新日期/Last Update: 2012-07-20