单心室的外科治疗

Surgical Treatment of Single Ventricle

目的 回顾总结单心室的手术治疗经验。 方法 1973年 1月～ 1999年 12月共纠治单心室 47例 ,其中包括右心室型 17例 ,左心室型 14例 ,另 16例诊断不明确。手术方式为肺动脉环缩术 1例 ,丰唐手术 (Fontanoperation) 2 3例 ,双向上腔静脉肺动脉吻合术 2 3例。 结果 全组死亡 7例 ,死亡率 15 % ;行双向上腔静脉肺动脉吻合术患者中无死亡。 结论 单心室患者早期必须采取手术治疗 ,防止肺部充血和严重缺氧。双向上腔静脉肺动脉吻合术能改善单心室的压力和容量负荷 ,降低手术死亡率 ,减少 Fontan手术的危险因素。

Objective\ To review and sum up experience of surgical repair of single ventricle.\ Methods\ Since January 1973 to December 1999, 47 patients with single ventricle have been repaired. Right ventricle type was 17 patients, left ventricle type was 14, and unrecorded type was 16. Surgical procedure consisted of pulmonary banding 1, Fontan operation 23, and bidirection superior cavopulmonary anastomosis 23.\ Results\ Seven patients died. The motality was 15%. There was no death in bidirection superior cavopulmonary anastomosis patients.\ Conclusion For the single ventricle, early surgical intervention is required to prevent pulmonary congestion and severe cyanosis. The bidirection superior cavopulmonary anastomosis can improve single ventricle function secondary to pressure and volume load to decrease surgical mortality and to minimize the risk factors for subsequent Fontan operation.