婴幼儿心脏手术后并发上腔静脉梗阻的临床诊断与治疗(附6例报告)

Clinical diagnosis and management of superior vena cava obstruction in infants after cardiac operations

目的 :探讨婴幼儿先天性心脏病体外循环术后上腔静脉梗阻 (SVCO)的临床表现、诊断方法及处理。方法 :1999年 1月至 2 0 0 3年 5月 ,我科共完成先天性心脏病手术 16 19例 ,其中 6例于术后第 5～ 38h出现SVCO征象 ,应用超声心动图及胸部平片诊断 ,经二次开胸探查并手术解除梗阻。结果 :所有病例术前诊断正确 ,手术效果良好 ,治愈出院。平均随访 (18± 4 )个月 ,患儿生长发育良好。结论 :SVCO是先天性心脏病围手术期少见的并发症 ,临床密切观察 ,结合心脏X线及超声检查 ,可以早期诊断。尽早开胸手术解除梗阻可以获得良好的疗效。

Objective：To explore clinical manifestations, diagnosis and treatment to superior vena cava obstruction（SVCO） after cardiac operations for congenital heart disease in infants. Method：Between January 1999 and May 2003, 1619 children with congenital heart disease underwent cardiac surgery, of whom 6 （0.37 % ） subsequently acquired SVCO 22±11 （5 - 38）hours postoperatively. All children were suspected by clinical manifestations and chest X-ray, diagnosed by echo. All patients were reoperated as soon as the diagnosis was established. Result： No death. Follow-up was 18 ±4 months. All patients were very well. Conclusion：SVCO is an uncommon complication after cardiac operations in children and the early diagnosis can be made by clinical manifestations, chest X-ray, and echo. SVCO should be treated by reoperation as soon as possible.