外科手术治疗儿童先天性心脏病的进展

儿童先天性心脏病外科治疗近年的发展趋势是尽可能在幼年手术,尽早改善全身供血供氧,并应在继发解剖病变加重之前手术矫正。 对于病情复杂、Ⅰ期根治手术死亡率高于分期手术的患儿,可采用减状手术。目前较常用的减状手术包括改良体-肺动脉分流术、Glenn手术、双向体静脉-肺动脉分流术、肺动脉束带术、房间隔造孔术。 复杂先心病常用的矫治手术分为双心室术式和单心室术式。前者包括大动脉转换术、房内转换术及Rastelli手术等,后者包括改良Fontan术及全腔静脉-肺动脉吻合术,Norwood手术。 对于终末期先心病或过于复杂的先心病可采用心脏移植或心肺移植,以取得较好的效果。 对于先心病合并重症肺动脉高压的治疗,目前已取得长足的进展,其重点在于注意术前、术中、术后全时段多手段综合处理。

Progress in Surgical Treatment of Pediatric Congenital Heart Disease

The tendency for the surgical treatment of pedi-atric congenital heart disease is to operate as early as possi-ble. Palliative operation such as systemic pulmonary andcavopulmonary shunts, pulmonary banding, et al, can beused for child suffering with complicated and severe con-genital heart disease. The corrected operation for compli-cated congenital heart disease can be classified as biventricleand univentricle type. The biventricle type include atrialswitch, Janete, and Rastelli surgery. The univentricle typeincludes Fonton surgery and total cavopulmonary connec-tion. For end - stage or/and uncorrectable congenital heartdisease, heart and heart - lung transplantation is usable. Forthe congenital heart disease complicated with severe pul-monary hypertension, the surgical treatment has archivedgood result due to whole perioperation period and multi-mesurement dealing.