成人先心病外科治疗相关研究进展.docVIP

成人先心病外科治疗相关研究进展 　　[摘要] 成人先天性心脏病，是指胎儿时期心血管发育异常对心功能产生实际或潜在影响的一组先天畸形患儿，得以存活至成年期，乃至中老年期。以往成人先天性心脏病病种较少，且多为简单畸形。近20年病种逐渐增多，特别是以接受外科手术治疗的复杂畸形逐年增多，包括复杂的大动脉转位和单心室类等。目前彩色多普勒超声心动图可作为筛查和确诊先心病的主要方法。治疗先心病近些年来以介入治疗]为首选，但成人先心病患者首选外科手术治疗，包括一期手术和分期手术，彻底纠正解剖结构，恢复心脏功能是治疗的关键。大多数患者手术后效果较好，但亦有术后多重并发症的发生，致使术后效果差，甚至死亡。其发病时间长，临床症状多在晚期，成人阶段症状显现，缺乏早期特异性，且具有潜在的致命性，导致临床工作中易出现漏诊、误诊，现对成人先心病外科治疗的相关研究进展进行综述。 　　[关键词] 成人先心病；外科治疗；生存率 　　[中图分类号] R541.1 [文献标识码] A [文章编号] 1673-9701（2015）14-0000-03 　　[Abstract] Adult congenital heart disease refers to a group of congenital malformations in children caused by the actual or potential of the cardiovascular abnormalities during the fetal period. Adult congenital heart disease was less in the past years. In the recent 20 years， the category of the disease gradually has increased， and especially the complex deformities demanding for surgical treatment increases every year， including complex great arteries translocation， single ventricle and so on. Currently， Color Doppler echocardiography can be used as the primary method for screening and diagnosis of congenital heart disease. In the recent years， the interventional therapy was preferred in the treatment of congenital heart disease， but surgical treatment， including one stage operation and staging operation was still preferred in the treatment of adult congenital heart disease for abnormal changes of structure， function and physical condition.Because the disease is congenital， the time of incidence is long， and clinical symptoms appear in late adulthood， lacking early-specificity， but with potentially fatality， it is prone to missed diagnosis and misdiagnosis in clinical work. Now， researches related to surgical treatment of adult congenital heart disease was reviewed. 　　[Key words] Adult congenital heart disease； Surgical treatment； Survival rate 　　成人先天性心脏病[1]，是由于现代医学技术的不断发展和先天性心脏病外科治疗水平的不断提高，越来越多的先心病患者得以存活到成年期[2]，乃至中老年期。此病因病程长或未能及早发现和治疗，导致重要并发症的发生及外科治疗过程中手术难度、危险系数的增加以及术后死亡率上升。但随着近二十年来我国心脏外科技术的快速提升，成人先心病