双向Glenn术在肺血减少型复杂先天性心脏病中的应用

Application of Bidirectional Glenn Shunt in Complex Congenital Heart Anomalies with Pulmonary Stenosis

目的探讨双向Glenn术在肺血减少型复杂先天性心脏病中的应用效果.方法常温体外循环下行双向Glenn术5例,年龄5～33岁,2例合并双侧上腔静脉,保留奇静脉,保留肺动脉前向血流.结果无死亡,术后SaO2(82.6±2.3)%,紫绀明显减轻,活动量增加.术后出现乳糜胸1例.结论掌握严格的适应症,双向Glenn术是治疗肺血减少型复杂先天性心脏病的一种安全有效的方法.

Objective To evaluate the application effects of bidirectional Glenn shunt in complex congenital heart anomalies with pulmonary stenosis. Methods 5 cases underwent bidirectional Glenn shunt with normothermie CPB. The age of patients was from 5 to 33 years old. 2 patients had bilateral superior venae cavae. The forward blood flows in azygos vein and pulmonary artery were preserved. Results There was no death after operation. The postoperative SaO2 was 82.6 ± 2.3%. This operation provided significant palliation of cyanosis and increasing of physical activities. 1 got chylothorax after operation. Conclusion If operation indications are controlled strictly, bidirectional Glenn shunt is an effective and safe treatment for the patients suffering from complex congenital heart anomalies with pulmonary stenosis.