完全性肺静脉异位连接的外科治疗(附7例报告)

目的总结7例完全性肺静脉异位连接的外科治疗经验。方法对我院自2002年3月至2006年2月收治的7例完全性肺静脉异位连接患者外科治疗方面的经验进行总结。其中心上型4例,心内型2例,混合型1例。结果手术死亡1例,为年龄最大患者(22岁),死亡原因复跳后发生低心排致脱机困难。其余6例术后呼吸机辅助6～17h。2例术后发生交界性心律,复查均在1个月内恢复窦性心律。术后随访3个月至4年,经皮氧饱和度均达97%以上,效果满意。结论完全性肺静脉异位连接须早期手术以防梗阻性肺动脉高压发生。手术关键是矫治彻底,避免术后出现远期肺静脉梗阻。术后预防肺水肿,加强呼吸道管理。

The surgical correction of total anomalous pulmonary venous connection

Objective To report the experience of surgical correction of total anomalous pulmonary venous connection(TAPVC). Methods 7 patients suffering from total anomalous pulmonary venous connection underwent surgical correction under moderate hypothermic cardiopulmonary bypass from 2002-2006. The classification included supracardiac type in 4 patients,intracardiac type in 2 patients and mixed-type in 1 patient. Results 1 patient(22 years old) died postoperatively,the cause of death was the patient could not be weaned from CPB. Six survivors had good convalescence during follow-up(from 3 months to 4 years). Conclusion Surgical correction of TAPVC should be performed as earlier as possible to prevent the development of pulmonary vascular lesions resulting from severe pulmonary hypertension.The key point is thoroughgoing surgical correction and prevention from obstruction of pulmonary venous connection postoperatively. Moreover.It is very important to strengthen the management of respiratory tract.