改良Norwood手术临床应用

目的总结改良Norwood手术的临床应用经验。方法2004年7月和2005年3月分别为1例7月龄单心室伴左心室流出道梗阻女婴,采用主肺动脉和主动脉弓下缘直接吻合、主动脉肺动脉人工血管分流完成改良Norwood手术;1例出生13 d左心发育不良综合征新生儿,采用主肺动脉和主动脉弓下缘直接吻合、右心室肺动脉人工血管分流完成改良Norwood手术。结果例1术后平稳,动脉压为85～100/25～40mmHg（1 mm Hg=0．133kPa）,动脉血氧饱和度为0．75～0．85,术后第3d撤离辅助呼吸,第11 d出院。例2术后平稳,动脉压为65～80／40～60mmHg,动脉血氧饱和度为0．67～0．89,术后第12 d撤离辅助呼吸,第28 d出院。结论改良Norwood手术的先进方法和技术,值得在我国推广应用。

Clinical experience with the modified Norwood procedure

Objective To review the clinical experience with the modified Norwood procedure. Methods Between July 2004 and March 2005, two infants with complex congenital heart disease underwent the modified Norwood procedures. The first patient, a seven months old girl with single ventricle and left ventricular outflow tract obstruction, underwent direct anastomosis reconstruction of aorta and aortic to pulmonary artery shunt. The second patient, a 13 days old boy with hypoplastic left heart syndrome, underwent direct anastomosis reconstruction of aorta and right ventricle to pulmonary artery conduit, Results The first patient had an uneventful postoperative course with arterial pressure 85 - 100/25 - 40 mmHg and arterial oxygen saturation 75% - 85%, and discharged on the eleventh postoperative day. The second patient also had an uneventful postoperative course with arterial pressure 65 - 80/40 - 60mmHg and arterial oxygen saturation 67% - 89%, and discharged on the 28th postoperative day. Conclusion Although we have little experience at present, the nxJdified Norwood procedure may be proceeded with modern techniques in China.