10例法洛四联症型右室双出口合并完全性房室间隔缺损中期随访.docVIP

精品论文 参考文献 10例法洛四联症型右室双出口合并完全性房室间隔缺损中期随访 黄艳 欧阳沙媛 龙静芬 黄尔佳 谭慧通讯作者 　　（中南大学湘雅二医院心血管外科；湖南长沙410000） 　　摘要：目的：总结分析10例法洛四联症性右室双出口合并完全性房室间隔缺损的手术方案，术后并发症及死亡率，以提高该类患儿手术存活率及改善其生活质量。资料与结果：2009年1月至2015年7月在我院接受手术治疗的10例法洛四联症性右室双出口合并完全性房室间隔缺损患儿。手术年龄6月~14岁，平均4.18plusmn;3.19岁。体重8.5~44kg，平均14.98plusmn;8.13kg。其中，根治手术2例，BT分流2例，Glenn分流4例，Fontan术2例。本组病例中近期死亡1例，死亡率为10%。全组平均呼吸机使用时间（54.94plusmn;70.07）h，ICU滞留时间平均为（5.23plusmn;5.65）天。死亡原因主要为：低心排综合征，瓣膜反流，三度房室传导阻滞。结论：符合根治手术条件的法洛四联症型DORV合并CAVSD可以取得良好的一期根治，复杂且双心室矫治困难的患儿仍可考虑行单心室矫治术。 　　关键词：法洛四联症型右室双出口，完全性房室间隔缺损，左室流出道梗阻，右室流出道梗阻。 　　the surgical result of the double outlet right ventricle with obstruction of right ventricular outlet and completely atrioventricular septal defect. 　　Abstract:Objective: To summarize the surgical result of the double outlet right ventricle with obstruction of right ventricular outlet(RVOTO) and completely atrioventricular septal defect(CAVSD). 　　Method: From January 2009 to July 2015, 10cases of DORV with RVOTO and CAVSD received the surgical treatment,including biventricular repair in 2 cases, BT shunt in 2 casese,Glenn shunt in 4 patineds and 2 in Fontan procedure. 　　Result: The Total mortality rate was 10% and only 1 patient were dead d after the Common atrioventricular valve replacement for the server regurgitation. The average duration of ventilation was 54.94 (70.07) hours, and the average residence time of ICU was (5.23 + 5.65)days. The main causes of death were low heart row syndrome, valvular regurgitation, third degree conduction block. 　　Conclusion: biventricular repair of the DORV with RVOTO and CAVSD can achieve good results. CAVSD may increase the mortality of the patients and Fontan procedure may be the alternative procedure of the beventricular repair. 　　Keywords: tetralogy of Fallot type double outlet right ventricle, complete atrioventricular septal defects, left ventricular outflow tract obstruction, right ventricular outflow tract obstruction. 　　右室双出口（DORV）是一类介于法洛四联症（TOF）和完全性大动脉转位（TGA）的中间状态，而DORV之间也存在中间