先天性双主动脉弓畸形的外科治疗

Early diagnosis and surgical treatment of congenital double aortic arch

目的总结双主动脉弓畸形外科治疗经验。方法外科治疗8例双主动脉弓病儿中男5例，女3例；年龄1～48个月，平均（14．93±15．52）个月；体重5．5-15kg，平均（9．56±3．51）kg。左右弓均衡型1例，右弓优势型7例。6例为单纯双主动脉弓畸形，均在胸部左后外侧切口进行矫治。另外1例合并室间隔缺损，肺动脉高压，1例合并肺动脉吊带，均在正中切口体外循环下进行矫治。结果7例术后积极治疗，均治愈出院。1例合并肺动脉吊带病儿因气管狭窄段长，呼吸困难严重，尽管血管畸形矫治满意，但仍不能脱离呼吸机，家属放弃治疗，自动出院。结论双主动脉弓是一种引起小儿严重呼吸系统感染的严重疾病，早发现，早治疗，手术治疗效果良好。

Objective Double aortic arch is one kind of vascular ring anomaly in congenital heart diseases, and the ordinary type. Most patients had severe compressing symptoms of trachea and esophagus. So early surgical intervene is very important. Methods 8 patients of double aortic arch in our hospital, male 5, female 3, received surgical treatment. Aged from 1 month to 48 months, mean （14.93 ± 15.52）months, weight from 5.5 kg to 15 kg, mean（9.56±3.51）kg. Amongthe patients, one was double arch syrmnetrieal type and the other were right arch predominant. 6 of them were pure double aortic arch who accepted operation through posterolateral incision on left chest. One of them combined with ventricle septal defect, another of them had pulmonary artery sling simultaneously. They both accepted operation trader CPB through median insicion. Resets 7 of them had good results after long term treatment of post-operation. One patient with severe stenosis of trachea was abandoned by his parents, because of depending respirator. Conclusion Double aortic arch is an important cause of persistent respiratory symptoms in infants and children, early investigation and surgical treatment means excellent outcomes.