小儿主动脉缩窄的诊断和外科治疗

Diagnosis and Surgical Correction of Coarctation of aorta in children

目的总结小儿主动脉缩窄的诊断方法和外科治疗经验。方法13例小儿主动脉缩窄患儿，年龄47天～12岁，体重4．5～27kg。9例行Gore－Tex补片扩大成形术；2例行缩窄段切除，端端吻合术；2例行左锁骨下动脉翻转降主动脉成形术。其中1例47天龄合并室间隔缺损及肺动脉高压的小婴儿一期同时行心内畸形矫治术。结果全部手术顺利，无手术死亡和术后并发症，随访疗效均满意。结论上下肢血压异常是本病的特征性表现；术式的选择宜因病变类型和术者的经验而异；多数患儿均可在常温下手术。

Objective To summarize the experience of diagnosis and surgical correction ofcoarctation of aorta in children. Methods Thirteen cases of coarctation were studied, ranging from 47 daysto 12 years in age, from 4. skg to 27kg. in weight, among which, 9 were performed by Gore-Tex patchaortoplasty, 2 by end to end anastomosis of the aorta with removal of the coarctated segment and 2 byaortoplasty with left subclavian flap. The diagnosis was made by characteristic sign hypertension ofupper limbs by means of echocardiogrsaphy and aortography. Results All had favourable outcome. Therewas no postoperative complication or death. Conclusion We must pay attention to the characteristicsign of hypertension in the upper limbs. The optimal age of the patient for surgical connection isdependent on his conditions. The majority of the patients can be operated on with cross-clamping of thedescending aorta under normothermia.