小儿三房心的诊断和外科治疗

Diagnosis and surgical treatment of cor triatriatum in children

目的:总结小儿三房心的临床诊断和外科治疗方法,以提高对该疾病的治疗效果。方法:我院自1996年1月至2011年8月共外科手术治疗小儿三房心24例,其中男14例,女10例,年龄7个月～15岁,平均(4.1±3.4)岁。本组完全型23例,部分型1例;单纯型2例,合并其他心内畸形22例。所有病例均采用右心房切口,通过右心房-房间隔径路显露左心房纤维隔膜,彻底切除异常隔膜,同期矫治合并的心内其他畸形。结果:24例患儿手术均矫治成功,无一例手术死亡,随访6个月～5年,术后恢复良好,心功能基本正常。结论:三房心明确诊断后要及时手术治疗;手术的关键在于仔细探查心内解剖关系和彻底矫正合并的畸形;三房心外科手术治疗效果良好。

Objective： To improve the therapeutic effect of cor triatriatum by summarizing its clinical diagnosis and surgical treatment in children. Methods： From January 1996 to August 2011, 24 patients aged from 7 months to 15 years （mean, 4.1 ＋ 3.4 years） with cor triatriatum were undergone operations under extracorporeal circulation. It comprised of 14 males and 10 females. Twenty-three cases were complete cor triatriatum and the left were partial type. Two cases presented as a simple type and 22 cases were combined with other cardiac abnormalities. All operations were carded out through the right atrial incision. The fibromuscular membranes were completely excised through the right atriurm-septal approach and the associated abnormalities were corrected at the same time. Results： There was no operative mortality, all cases were surgical treated successfully. The survivors who were followed up 6 months to 5 years after surgery had good outcome and their heart function returned to normal level. Conclusion： The operation should be treated timely once the diagnosis of cot triatriatum is clear. Surgical results of cot triatriatum depend on both probing intracardiac anatomy carefully and complete correction of associated cardiac abnormalities. The result of surgical treatment for cor triatriatum is satisfactory