临床小儿外科杂志2016，Vol.15Issue(3)：219-224,245,7.DOI:10.3969/j.issn.1671-6353.2016.03.005
两种手术方法对肺动脉闭锁伴室间隔缺损预后影响的探讨
One-stage surgical treatment of pulmonary atresia with ventricular septal defect
摘要
Abstract
Objetive To summarize the one-stage complete procedures of pulmonary atresia with ven-tricular septal defect (PA /VSD)in recent years,explore the reconstruction methods of right ventricular outflow tract,make a comparative analysis with index after procedure and compare the situations with others palliative procedures at the same time.Methods Retrospective reviews were conducted for 129 cases of one-stage com-plete procedures from January 2008 to March 2014.The relevant parameters included gender,age,height, weight,preoperative percutaneous oxygen saturation,McGoon index,Nakata index,surgical procedure,recon-struction materials of right ventricular outflow tract,cardiopulmonary bypass (CPB)time,aortic clamping time and hospital stay length and postoperative inotropic score.Comparisons were made with 120 cases of palliative procedures at the same time.Results The mortality rate of one -stage complete procedure group was 7.8%and the mortality rate of palliative procedures was 9.2%.Significant inter-group differences existed in McGoon index,SpO2 ,CPB time and ventilation time.Cardiac intensive care unit (CICU),hospitalization duration, CPB time,ACC time and McGoon index were significantly associated with the occurrence of low cardiac output syndrome. Conclusions Preoperative McGoon index ≥1.2,SpO2≥75% may become an indication for radi-cal surgery.And monitoring of RVP/LVP ratio prevents early hospital mortality.For concurrent major aortopul-monary collateral artery,early radical surgery should be promoted.关键词
肺动脉/畸形/室间隔缺损/外科手术/治疗/儿童Key words
Pulmonary Artery/AB/Heart Septal Defects,Ventricular/Surgical Procedures,Operative/Therapy/Child引用本文复制引用
郁夏风,刘锦纷,董卫..两种手术方法对肺动脉闭锁伴室间隔缺损预后影响的探讨[J].临床小儿外科杂志,2016,15(3):219-224,245,7.基金项目
国家自然科学基金，项目号81501558 （）
