ISSN 1674-3865  CN 21-1569/R
主管：国家卫生健康委员会
主办：中国医师协会
　　　辽宁省基础医学研究所
　　　辽宁中医药大学附属医院
中国中西医结合儿科学

中国中西医结合儿科学 ›› 2023, Vol. 15 ›› Issue (3): 185-189.

• 小儿心血管疾病康复专栏 •    下一篇

肺动脉闭锁合并室间隔缺损不同姑息手术方式临床疗效分析

  

  • 出版日期:2023-06-25 上线日期:2023-11-22

Clinical effect analysis of different palliative operation methods for pulmonary atresia with ventricular septal defect

  • Published:2023-06-25 Online:2023-11-22

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摘要： 目的 比较体-肺分流术和姑息性右心室肺动脉(RV-PA)连接术两种不同姑息手术方式在肺动脉闭锁合并室间隔缺损(PA/VSD)中的临床疗效。方法 回顾性分析2000年1月至2021年6月于复旦大学附属儿科医院行分期手术治疗的49例PA/VSD患儿的临床资料，比较两种不同姑息手术患儿围手术期结果和术后肺血管发育程度。结果 中位随访时间为2.4(1.2,3.3)年。体-肺分流术组(n=31)和姑息性RV-PA连接术组(n=18)术后早期死亡率、严重并发症发生率、术后机械通气时间、心脏监护室(CCU)滞留时间和两次手术间隔时间比较差异均无统计学意义(P>0.05)。49例PA/VSD患儿术后经皮氧饱和度、McGoon比值及Nakata指数均较术前增加，差异有统计学意义(P<0.05),且姑息性RV-PA连接术组术后经皮氧饱和度高于体-肺分流术组，差异有统计学意义(P<0.05)。结论 姑息性RV-PA连接术与体-肺分流术均可促进PA/VSD患儿肺动脉发育。其中，姑息性RV-PA连接术组患儿术后氧合情况改善更明显

关键词: 肺动脉闭锁合并室间隔缺损, 体-肺分流术, 姑息性右心室肺动脉连接术

Abstract: ObjectiveTo compare the clinical efficacy between the systemic-to-pulmonary artery shunt surgery and palliative right ventricular to pulmonary artery (RV-PA) connection in patients with pulmonary atresia with ventricular septal defect (PA/VSD).MethodsWe retrospectively analyzed the clinical data of 49 children with PA/VSD who received palliative surgery in the Pediatric Hospital of Fudan University from January 2001 to June 2021,and compared the perioperative results and therapeutic effect of the two kinds of palliative surgery as well as the postoperative pulmonary vascular development.ResultsMedian follow-up time was 2.4 (1.2,3.3) years.There were no significant differences in the early postoperative mortality,complication rate,postoperative mechanical ventilation time,CCU retention time or the interval between two operations between the systemic-to-pulmonary shunt group(n=31) and the palliative RV-PA connection group(n=18)(P>0.05).Postoperative percutaneous oxygen saturation,McGoon ratio and Nakata index were increased in both groups compared with those before surgery (P<0.05).Postoperative percutaneous oxygen saturation in the palliative RV-PA connection group was higher than that in the systemic-to-pulmonary shunt group,and the difference was statistically significant(P<0.05).ConclusionBoth palliative RV-PA connection and systemic-to-pulmonary arterial shunt surgery can promote pulmonary artery development in children with PA/VSD,among which the improvement in postoperative oxygenation is more obvious in the palliative RV-PA connection group

Key words:

Pulmonary atresia with ventricular septal defect, Systemic-to-pulmonary arterial shunt surgery, Palliative right ventricular to pulmonary artery connection(RV-PA) surgery