新生儿室间隔完整型肺动脉闭锁 Hybrid 手术预后分析_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

王宁 , 刘大为 , 刘宇航 , 赵烨 , 高明磊 , 卢旭宁 , 朱全伟 ,  文平

大连医科大学附属大连市儿童医院心外科（辽宁大连 116012）;

Corresponding author：

文平, Email: 13504115999@163.com

Keywords：

新生儿; 室间隔完整型肺动脉闭锁; Hybrid 手术; B-T 分流术

DOI：

10.7507/1007-4848.201801006

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

目的探讨室间隔完整型肺动脉闭锁（pulmonary atresia with intact ventricular septum，PA/IVS）新生儿行 Hybrid 手术的预后。方法回顾性分析 2015 年 7 月至 2017 年 11 月我院行 Hybrid 手术（食管超声引导下经胸切口右室流出道途径球囊扩张肺动脉瓣联合 BT 分流术） 9 例 PA/IVS 新生儿的临床资料，其中男 6 例、女 3例，手术年龄23（17～29）d。结果 9 例新生儿手术顺利，手术时间 112（95～147）min。1 例死于肺部严重感染，余 8 例均顺利出院。8 例存活患儿机械通气时间 31（22～47）h，住院时间 17（12～23）d，出院时 8 例平均血氧饱和度升至 87.5%，平均右室收缩压降至 49 mm Hg，肺动脉瓣跨瓣压降至 28（21～46）mm Hg。1 例术后发生短暂的室上性心动过速，5 例患儿因为术中失血给予了输血，3 例患儿出现肺动脉瓣少量反流，1 例患儿出现肺动脉瓣中量反流，无 1 例患儿发生心脏穿孔、主肺动脉瘤或低心排血量综合征。随访时间为 17.5（7～26）个月。5 例患儿已完成根治手术，3 例患儿等待行根治手术。结论相对传统外科手术和经皮介入术，Hybrid 手术治疗可作为一种安全有效的替代治疗手段，对于条件合适的 PA/IVS 新生儿可获得满意的预后。

Citation： 王宁, 刘大为, 刘宇航, 赵烨, 高明磊, 卢旭宁, 朱全伟, 文平. 新生儿室间隔完整型肺动脉闭锁 Hybrid 手术预后分析. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2018, 25(10): 910-913. doi: 10.7507/1007-4848.201801006 Copy

1.	滕云, 庄建, 陈寄梅, 等. Ⅰ 型肺动脉闭锁姑息术和根治术的比较. 中国胸心血管外科临床杂志, 2017, 24(1): 48-51.
2.	Li QZ, Cao H, Chen Q, et al. Balloon valvuloplasty through the right ventricle: another treatment of pulmonary atresia with intact ventricular septum. Ann Thorac Surg, 2013, 95(5): 1670-1674.
3.	冯梅, 凌云飞. 华西医院成功为新生儿心脏病患儿实施杂交手术. 中国胸心血管外科临床杂志, 2014, 21(4): 456-456.
4.	Schwartz MC, Glatz AC, Dori Y, et al. Outcomes and predictors of reintervention in patients with pulmonary atresia and intact ventricular septum treated with radiofrequency perforation and balloon pulmonary valvuloplasty. Pediatr Cardiol, 2014, 35(1): 22-29.
5.	陈忠建, 李芳, 翟波, 等. 动脉导管内支架治疗新生儿室间隔完整型肺动脉闭锁的疗效分析. 中华实用儿科临床杂志, 2016, 31(23): 1795-1798.
6.	Hu R, Zhang H, Dong W, et al. Transventricular valvotomy for pulmonary atresia with intact ventricular septum in neonates: a single-centre experience in mid-term follow-up. Eur J Cardiothorac Surg, 2015, 47(1): 168-172.
7.	Hata H, Sumitomo N, Ayusawa M, et al. Biventricular repair of pulmonary atresia with intact ventricular septum and severely hypoplastic right ventricle: a case report of a minimum intervention surgical approach. J Cardiothorac Surg, 2016, 11(1): 94.
8.	Alwi M, Budi RR, Mood MC, et al. Pulmonary atresia with intact septum: the use of Conquest Pro coronary guidewire for perforation of atretic valve and subsequent interventions. Cardiol Young, 2013, 23(2): 197-202.
9.	Mallula K, Vaughn G, El-Said H, et al. Comparison of ductal stenting versus surgical shunts for palliation of patients with pulmonary atresia and intact ventricular septum. Catheter Cardiovasc Interv, 2015, 85(7): 1196-1202.
10.	Schneider AW, Blom NA, Bruggemans EF, et al. More than 25 years of experience in managing pulmonary atresia with intact ventricular septum. Ann Thorac Surg, 2014, 98(5): 1680-1686.
11.	李渝芬, 李俊杰, 石继军, 等. 新生儿危重肺动脉瓣狭窄及室间隔完整型肺动脉瓣闭锁经导管介入治疗的短中期随访. 中华儿科杂志, 2012, 50(12): 925-928.
12.	Rathgeber S, Auld B, Duncombe S, et al. Outcomes of radiofrequency perforation for pulmonary atresia and intact ventricular septum: A single-centre experience. Pediatr Cardiol, 2017, 38(1): 170-175.
13.	Zheng J, Gao B, Zhu Z, et al. Surgical results for pulmonary atresia with intact ventricular septum: a single-centre 15-year experience and medium-term follow-up. Eur J Cardiothorac Surg, 2016, 50(6): 1083-1088.
14.	陈纲, 吴琳, 刘芳, 等. 经右室肺动脉瓣成形术治疗室间隔完整型肺动脉闭锁的中期随访. 中华小儿外科杂志, 2016, 37(2): 85-90.
15.	谢静, 孙锟. 室间隔完整型肺动脉闭锁的诊断及介入治疗发展. 上海交通大学学报, 2014, 34(5): 759-762.

1. 滕云, 庄建, 陈寄梅, 等. Ⅰ 型肺动脉闭锁姑息术和根治术的比较. 中国胸心血管外科临床杂志, 2017, 24(1): 48-51.
2. Li QZ, Cao H, Chen Q, et al. Balloon valvuloplasty through the right ventricle: another treatment of pulmonary atresia with intact ventricular septum. Ann Thorac Surg, 2013, 95(5): 1670-1674.
3. 冯梅, 凌云飞. 华西医院成功为新生儿心脏病患儿实施杂交手术. 中国胸心血管外科临床杂志, 2014, 21(4): 456-456.
4. Schwartz MC, Glatz AC, Dori Y, et al. Outcomes and predictors of reintervention in patients with pulmonary atresia and intact ventricular septum treated with radiofrequency perforation and balloon pulmonary valvuloplasty. Pediatr Cardiol, 2014, 35(1): 22-29.
5. 陈忠建, 李芳, 翟波, 等. 动脉导管内支架治疗新生儿室间隔完整型肺动脉闭锁的疗效分析. 中华实用儿科临床杂志, 2016, 31(23): 1795-1798.
6. Hu R, Zhang H, Dong W, et al. Transventricular valvotomy for pulmonary atresia with intact ventricular septum in neonates: a single-centre experience in mid-term follow-up. Eur J Cardiothorac Surg, 2015, 47(1): 168-172.
7. Hata H, Sumitomo N, Ayusawa M, et al. Biventricular repair of pulmonary atresia with intact ventricular septum and severely hypoplastic right ventricle: a case report of a minimum intervention surgical approach. J Cardiothorac Surg, 2016, 11(1): 94.
8. Alwi M, Budi RR, Mood MC, et al. Pulmonary atresia with intact septum: the use of Conquest Pro coronary guidewire for perforation of atretic valve and subsequent interventions. Cardiol Young, 2013, 23(2): 197-202.
9. Mallula K, Vaughn G, El-Said H, et al. Comparison of ductal stenting versus surgical shunts for palliation of patients with pulmonary atresia and intact ventricular septum. Catheter Cardiovasc Interv, 2015, 85(7): 1196-1202.
10. Schneider AW, Blom NA, Bruggemans EF, et al. More than 25 years of experience in managing pulmonary atresia with intact ventricular septum. Ann Thorac Surg, 2014, 98(5): 1680-1686.
11. 李渝芬, 李俊杰, 石继军, 等. 新生儿危重肺动脉瓣狭窄及室间隔完整型肺动脉瓣闭锁经导管介入治疗的短中期随访. 中华儿科杂志, 2012, 50(12): 925-928.
12. Rathgeber S, Auld B, Duncombe S, et al. Outcomes of radiofrequency perforation for pulmonary atresia and intact ventricular septum: A single-centre experience. Pediatr Cardiol, 2017, 38(1): 170-175.
13. Zheng J, Gao B, Zhu Z, et al. Surgical results for pulmonary atresia with intact ventricular septum: a single-centre 15-year experience and medium-term follow-up. Eur J Cardiothorac Surg, 2016, 50(6): 1083-1088.
14. 陈纲, 吴琳, 刘芳, 等. 经右室肺动脉瓣成形术治疗室间隔完整型肺动脉闭锁的中期随访. 中华小儿外科杂志, 2016, 37(2): 85-90.
15. 谢静, 孙锟. 室间隔完整型肺动脉闭锁的诊断及介入治疗发展. 上海交通大学学报, 2014, 34(5): 759-762.

Previous Article
右心辅助在心脏移植术后急性右心衰竭中的临床应用
Next Article
电视胸腔镜手术中心性非小细胞肺癌支气管袖式切除的病例对照研究

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

新生儿室间隔完整型肺动脉闭锁 Hybrid 手术预后分析

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content