儿童右心室双出口的外科治疗

目的 探讨外科治疗儿童右心室双出口（DORV）方法及疗效。方法 对收治的28例DORV患者，26例在体外循环下手术，其中16例心室内隧道构建VCD－AO通道、Rastelli手术2例、单纯右心室流出首 片加宽术3例、改良Fontan 手术2例、Glenn手术1例、肺动脉束带及房间隔缺损扩大术2例。肺动脉束带术1例，改良Wat erson手术1例。结果 术后早期死亡8例，病死率29％。1998年至今19例中死亡4例。存活的20例至今无死亡。结论 只要诊断明确并掌握好各种术式的适应证，DORV的手术病死率必然进一步下降。

Surgical management of double outlet of right ventricle in children

Objective To evaluate the efficacy of surgical management of double outlet right ventricle (DORV) in children. Methods 28 chlidren with DORV were treated by operations. Intraventricular baffle was inserted in 16 children while Rastelli procedure was performed in 2 cases. 3 cases underwent simply right ventricular outflow tract enlargement by mean of baffle. Modified Fontan procedure was performed in 2 case and Glenn procedure performed in 1 case. There were also 2 cases of pulmonary artery banding plus ASD enlargement. 1 case was only operated on by pulmonary banding. Modified Waterson procedure was applied to other cases. Results 8 in this group died postoperatively, with the mortality 29%. The remaining 20 children have survived. Conclusion With correct diagnosis and selection of procedure, the mortality of surgical management of DORV will decrease further.