主-肺动脉间隔缺损的外科治疗

Surgical treatment of aortopulmonary septal defect

目的探讨主肺动脉间隔缺损的外科治疗。方法１９８３年１月至１９９６年１２月间，手术治疗主肺动脉间隔缺损患者５例，其中男２例，女３例；年龄６～３４岁（平均１７４岁）。按Ｍｏｒｉ分型：Ⅰ型２例，Ⅱ型２例，Ⅲ型１例。缺损直径１０～３０ｃｍ。手术均在全身麻醉、中度低温、体外循环下进行。３例经肺动脉切口，２例经主动脉切口，以绦纶毡片修补。结果５例均痊愈出院，术后随访１０个月～１２年，情况良好。结论本病确诊后应尽早手术，手术方法宜采用体外循环下修补，主动脉切口优于肺动脉切口。

Objective To study the surgical treatment of aortopulmonary septal defect. Method From January 1983 to December 1996,5 patients with aortopulmonary septal defect (APSD) (2 male and 3 female) aged from 6 to 34 years (mean 174 years) underwent surgical treatment.According to Mori′s were classification,5 patients belonged to type Ⅰ, 2 type Ⅱ and 1 type Ⅲ.The diameters of the defect ranged from 10 to 30 cm.The operations were performed under moderate hypothermic cardiopulmonary bypass.Pulmonary artery incision was performed, in 3 patients while aortic incision in the other 2. All defects were repaired by Dacron patch. Result There were no operative deaths and postoperative complications.During followup of 10 months to 12 years,no late complications and deaths were found. Conclusion The operation should be done early as possible whenever the diagnosis is established.The surgical repair chould be taken under cardiopulmonary bypass.To chose an incision on the aorta is more reasonable than on the pulmonary artery.The use the dacron patch can prevent stenosis and recanalization after operation.