婴幼儿心脏手术后并发上腔静脉梗阻的临床诊断与治疗(附6例报告)

目的 :探讨婴幼儿先天性心脏病体外循环术后上腔静脉梗阻 (SVCO)的临床表现、诊断方法及处理。方法 :1999年 1月至 2 0 0 3年 5月 ,我科共完成先天性心脏病手术 16 19例 ,其中 6例于术后第 5～ 38h出现SVCO征象 ,应用超声心动图及胸部平片诊断 ,经二次开胸探查并手术解除梗阻。结果 :所有病例术前诊断正确 ,手术效果良好 ,治愈出院。平均随访 (18± 4 )个月 ,患儿生长发育良好。结论 :SVCO是先天性心脏病围手术期少见的并发症 ,临床密切观察 ,结合心脏X线及超声检查 ,可以早期诊断。尽早开胸手术解除梗阻可以获得良好的疗效。

Clinical diagnosis and management of superior vena cava obstruction in infants after cardiac operations

Objective:To explore clinical manifestations, diagnosis and treatment to superior vena cava obstruction(SVCO) after cardiac operations for congenital heart disease in infants.Method:Between January 1999 and May 2003, 1?619 children with congenital heart disease underwent cardiac surgery, of whom 6 (0.37%) subsequently acquired SVCO 22±11(5～38)hours postoperatively. All children were suspected by clinical manifestations and chest X-ray, diagnosed by echo. All patients were reoperated as soon as the diagnosis was established.Result:No death. Follow-up was 18±4 months. All patients were very well.Conclusion:SVCO is an uncommon complication after cardiac operations in children and the early diagnosis can be made by clinical manifestations, chest X-ray, and echo. SVCO should be treated by reoperation as soon as possible.