New pericardial suture for repair of total anomalous pulmonary venous connection: early experience
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摘要: 目的 展示一种新的缝合方法在完全性肺静脉异位引流(TAPVC)手术中的应用效果。方法 本报告研究了14例TAPVC，男8例，女6例。平均年龄为(27.4±15.9) d。心上型12例，心下连接2例。TAPVC的校正在中度低温体外循环下进行，平均CPB时间为(119.0±18.6) min，平均阻断时间(82.5±16.3) min。结果 无术中死亡。手术后无死亡。14例患者均接受了至少3个月的随访，与对照组相比，术后呼吸机使用时间、ICU驻留时间均优于对照组；远期吻合口通畅程度与对照组无明显区别。结论 新的心包缝合法是治疗婴儿TAPVC患者的一种可行、安全且相对有效的方法。
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关键词:
- 完全性肺静脉异位引流 /
- 心包 /
- 肺静脉梗阻
Abstract: To demonstrate the modified surgical treatment of total anomalous pulmonary venous connection(TAPVC).Methods 14 cases of TAPVC were studied in this report. There were 8 males and 6 females. Mean age is 27.4±15.9 days. 12 patients are supracardiac type, 2 patients are infracardiac connection. Correction of TAPVC was performed under moderate hypothermic cardiopulmonary bypass, mean CPB time is 119.0±18.6 mins, mean arrest time82.5±16.3mins.Results There is no intraoperative death. No death after surgery. 14 patients were all followed up at least 3 months, compared with the control group, time of postoperative ventilator supporting and ICU staying are shorter than those of the control group. The long-term anastomotic patency is not significantly different from the control groupConclusion Modified pericardial repair is a feasible, safe, and relatively effective method for treating infant TAPVC patients. -
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表 1 临床资料
Table 1. General data
X±S 项目 心包缝合组(14例) 对照组(12例) t P 性别/例 男 8 8 女 6 4 体重/kg 3.42±0.45 3.65±0.88 -0.863 0.135 年龄/岁 27.4±15.9 28.3±23.9 -0.115 0.247 分类/例 心上型 12 11 心下型 2 1 体外循环时间/min 119.0±18.6 128.4±30.4 -0.969 0.026 阻断时间/min 82.5±16.3 78.8±25.1 0.448 0.222 呼吸机时间/h 62.8±60.8 102.9±96.3 -1.551 0.026 ICU驻留时间/d 7.8±5.1 12.1±8.8 -1.583 0.020 
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表 2 术后随访吻合口流速
Table 2. Postoperative follow-up
m/s, X±S 项目 心包缝合组(14例) 对照组(12例) t P 随访期7 d 1.17±0.12 随访期90 d 1.29±0.09 1.67±0.15 -7.841 0.111
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