非心肺转流术双向腔肺分流术的疗效分析

Clinical efficacy of bidirectional Glenn shunt with non-cardiopulmonary bypass

目的探讨非心肺转流术（cPB）双向腔肺分流术（Glenn术）治疗先天陛心脏病的临床疗效。方法回顾性分析2005年8月至2011年8月44例行双向腔肺分流术患者的临床资料，其中采用非CPB患者23例（非CPB组），CPB患者21例（CPB组），对比分析两组患者呼吸机辅助呼吸时间、胸腔引流量、血液制品使用量、术后住院时间和出院时脉搏血氧饱和度（SpO：）。结果44例患者均治愈出院，无死亡病例。非CPB组呼吸机辅助呼吸时间、胸腔引流量和血液制品使用量分别为（4．5±1．3）h、（4．6±1．4）ml／kg和（221．8±97．6）ml，均明显少于CPB组的（6．7±1．5）h、（7．7±3．1）m]]kg和（423．4±149．7）ml，差异有统计学意义（P〈0．05），非CPB组术后住院时间和出院时SpO，分别为（7．4±2．3）d和0．91±0．05，而CPB组为（7．8±1．9）d和0．88±0．39，两组比较差异无统计学意义（P〉0．05）。结论在非CPB下施行双向腔肺分流术是一种安全、可行的手术，值得临床推广。

Objective To investigate the clinical efficacy of bidirectional Glenn shunt with non- cardiopulmonary bypass （CPB） for treating congenital heart disease. Methods The clinical data of forty- four patients receiving bidirectional Glenn shunt from August 2005 to August 2011 were analyzed retrospectively, twenty-three cases of which were treated by bidirectional Glenn shunt with non-CPB （non- CPB group） and twenty-one With CPB （CPB group）. The duration of ventilator-assisted breathing, chest drainage volume, amount of blood product usage, postoperative hospital stay and pulse oxygen saturation （SpO2） before leaving the hospital were compared and analyzed between two groups. Results Forty-four patients were all cured. The duration of ventilator-assisted breathing, chest drainage volume and the amount of blood product usage of non-CPB group were less than those of CPB group [ （4.5± 1.3 ） h vs. （6.7 ± 1.5 ） h, （4.6 ± 1.4） ml/kg vs. （7.7 ± 3.1 ） ml/kg, （221.8 ± 97.6） ml vs. （423.4 ±149.7） ml,P〈 0.05]. There was no significant difference of the postoperative hospital stay and SpO2 before leaving the hospital between non-CPB group and CPB group[ （7.4 ±2.3） d vs. （7.8±1.9） d, 0.91±0.05 vs. 0.88 ± 0.39,P〉 0.05]. Conclusion Bidirectional Glenn shunt with non-CPB is a safe and feasible surgical approach, which is worthy of promotion.