我们的网站为什么显示成这样？

可能因为您的浏览器不支持样式，您可以更新您的浏览器到最新版本，以获取对此功能的支持，访问下面的网站，获取关于浏览器的信息：

|本期目录/Table of Contents|

完全性心内膜垫缺损并发右室流出道狭窄的外科治疗

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2014年第6期
页码:
713-716
栏目:
临床研究
出版日期:
2014-06-25

文章信息/Info

Title:
Surgical treatment for patients with total endocardial cushion defect and right ventricular outflow tract obstruction
作者:
张刚成; 李珊珊; 陶 凉
(武汉亚洲心脏病医院心胸外科、先天性心脏病中心，湖北 武汉 430022)
Author(s):
ZHANG Gang-cheng;  LI Shan-shan;  TAO Liang
(Department of Cardiothoracic Surgery, Wuhan Asia Heart Hospital, Wuhan 430022, Hubei, China)
关键词:
完全性心内膜垫缺损; 右室流出道狭窄; 外科治疗; 随访
Keywords:
total endocardial cushion defect;  right ventricular outflow tract obstruction;  surgical treatment;  follow-up
分类号:
R541.1
DOI:
-
文献标识码:
A
摘要:
目的:对近10年来26例完全性心内膜垫缺损（TECD）并发右室流出道狭窄(PS)患者进行了外科手术并进行了随访，以了解不同手术方式的效果。方法： 2003年11月~2012年12月共有26例TECD+各种PS患者接受了外科手术，男10例，女16例，年龄3个月~24(8±7)岁，体质量6~52(22±14) kg。手术方法有双心室矫治、单心室矫治和姑息手术。随访依据门诊复查结果(包括病史、体格检查、心电图、X线胸片和超声心动图检查)及电话随访。结果： 26例患儿双心室矫治12例(46%)，单心室矫治9例(35%)，姑息手术5例(19%)。近期死亡9例(35%)，住院生存患儿17例，随访期限为术后5~84（平均12.8）个月。晚期死亡1例(4%)。结论： TECD并发各种类型的PS，手术复杂，手术近期死亡率高，但中远期生存率较好。在同等条件下，双心室矫治较单心室矫治及姑息手术远期预后更好。
Abstract:
AIM:To investigate the postoperative early and mid-term effect of different surgical methods for patients with total endocardial cushion defect and right ventricular outflow tract obstruction. METHODS: Twenty-six patients with total endocardial cushion defect with various right ventricular outflow tract stenosis underwent surgery from November 2003 to December 2012, of whom ten were males and 16 females, aged 3 months-24 years old (7.9±6.7) years and weighing 6-52(22.3±14.5) kg. Surgical approaches carried out were biventricular correction, single ventricle correction and palliative surgery. Follow-up included out-patient review (case history, physical examination, electrocardiogram, chest X-ray and echocardiography) and telephone survey. RESULTS: Among the 26 cases, 12(46.2%) underwent biventricular correction, 9(34.6%) single ventricle correction and five (19.2%) palliative surgery. Nine cases (34.6%) of early death occurred and the other 17 cases survived during hospitalization. The follow-up period after surgery was 5-84 months (mean 12.8 months) and one case (3.8%) of late death occurred. CONCLUSION: Patients with total endocardial cushion defect and various types of right ventricular outflow tract obstruction have a low natural survival rate. The surgical procedure is complex and has a very high early death rate for atrioventricular valve regurgitation of any degree, regardless of the surgical approach. However, surgical procedures have a relatively better long-term survival rate. Compared with single ventricle correction and palliative surgical treatment, biventricular correction has a relatively better long-term prognosis.

参考文献/References

[1]汪曾炜,刘维永,张宝仁.心血管外科手术学[M].北京:人民军医出版社,2005:401.
[2]张惠丽，李守军，胡盛寿，等.室间隔缺损远离两大动脉开口右心室双出口的术后早中期随访结果报道[J].中国循环杂志,2009,24(6):461-464.
[3]李富骊，尤 斌，李 平，等.完全性心内膜垫缺损合并右室双出口的双心室修复[J].中华胸心血管外科杂志,2011,27(4):197-199.
[4]吴清玉，郭宏伟，沈向东，等.完全房室间隔缺损合并法洛四联症或联症型右心室双出口的解剖矫治[J].中华医学杂志,2004,84(6):486-488.
[5]Ruzmetov M,Rodefeld MD,Turrentine MW,et al.Rational approach to surgical management of complex forms of double outlet right ventricle with modified Fontan operation[J].Congenit Heart Dis,2008,3(6):397-403.
[6]吴向阳，陶 凉，孙善权，等.婴幼儿复杂先天性心脏病的外科治疗[J].中国心胸血管外科临床杂志,2009,16(6):440-444.

备注/Memo

备注/Memo:
收稿日期：2013-11-08.
基金项目：2013年武汉市科研项目资助（WX13C47）；2013年湖北省科研项目资助（JX6B90）
作者简介：张刚成，副主任医师Email： zhanggangchen@medmail.com.cn
更新日期/Last Update: 2014-07-10