新生儿及婴幼儿完全型肺静脉异位引流的外科治疗

Surgical treatment of total anomalous pulmonary venous connection in neonates and infants

目的通过本中心近年来完全型肺静脉异位引流(TAPVC)的外科治疗经验,回顾总结新生儿及婴幼儿TAPVC的手术方式及治疗效果。方法 2015年1月至2018年2月,本院共收治完全型肺静脉异位引流101例,男48例,女53例。体重2.5～10(6.28±1.73) kg。年龄7 d～12个月,平均年龄(4.45±2.55)个月。心上型39例,心内型48例,心下型8例,混合型6例。所有患儿均在全麻低温体外循环下行外科矫治手术。结果 2例死亡,余患者术后顺利出院,随访时间为1个月至3年,患者术后心功能良好,无吻合口狭窄等远期并发症。结论完全型肺静脉异位引流早期外科矫治效果良好,手术成功与患者术后康复效果的关键在于保证吻合口的通畅,避免吻合口和肺静脉狭窄。根据不同的分型及患者具体情况选择合适的手术方式,尽可能大的保证吻合口,往往能够取得满意的外科治疗效果。

Objective To review surgical experiences of total anomalous pulmonary venous connection in neonates and infants in our institution.Methods The clinical data of 101 patients with TAPVC undergoing surgical treatments in our center from January 2015 to Feburary 2018 were retrospectively reviewed.There were 48 male and 53 female patients,respectively.The age of the patients ranged from 7 days to 12 months(4.45±2.55 months) .Their weight ranged from 2.5 to 10 (6.28±1.73) kg.Results Ninety-nine patients were discharged from the hospital uneventfully while two patients were died.The follow-up time ranged from 1 month to 3 years,and almost all patients showed good cardiac function postoperatively. Conclusion Surgical correction in patients with TAPVC can achieve satisfactory outcome.