快速与长期双期大动脉调转术在室间隔完整大动脉转位中应用的对比研究

目的通过比较快速和长期双期大动脉调转术(ASO)的组间特点,总结发生左室退化后室间隔完整大动脉转位(TGA-IVS)的手术治疗经验。方法纳入2007年1月至2019年1月主要诊断为TGA-IVS并行双期ASO的患儿41例,其中男25例、女16例,平均年龄17.9个月(7 d至7岁)。根据双期手术间隔时间,分为快速双期ASO组(19例)和长期双期ASO组(22例)。比较两组患儿临床效果。结果两组患儿的年龄、体重、ASO术前血氧饱和度、训练术前左室舒张期末内径、ASO术前左室后壁厚度差异均有统计学意义(P<0.05)。患儿年龄>1岁是进行长期双期ASO的独立危险因素。结论长期双期ASO对年龄>1岁和左心室退化严重的患儿具有良好的疗效。

Comparative study of rapid and long-term two-stage arterial switch operation in treatment of transposition of the great arteries with intact ventricular septal

Objective To summarize the experience of surgical treatment of transposition of the great arteries with intact ventricular septal(TGA-IVS)after left ventricular regression by comparing the characteristics of rapid and long-term two-stage arterial switch operation(ASO).Methods Forty-one patients who were mainly diagnosed with TGA-IVS from January 2007 to January 2019 and underwent two-stage ASO were included.They were divided into a rapid two-stage ASO group(19 patients)and a long-term two-stage ASO group(22 patients)according to the interval of left ventricular training surgery and ASO.The clinical effectiveness of the two groups was compared.Results There was a statistical difference in age,body weight,blood oxygen saturation before ASO,end diastolic diameter of left ventricle before training,and thickness of posterior left ventricular wall before ASO(P<0.05).Children older than 1 year was an independent risk factor for long-term two-stage ASO.Conclusion Long-term two-stage ASO is suitable for children who are older than 1 year and who have severe left ventricular regression.