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find Author "纪志娴" 3 results
  • 非体外循环双向Glenn手术治疗小儿复杂先天性心脏病

    目的 总结非体外循环双向Glenn手术在小儿复杂先天性心脏病中的应用经验。 方法 2005年4月至2008年8月,青岛市儿童医院收治22例先天性心脏病患者,男14例,女8例;年龄10个月~7岁,平均年龄3.0岁;体重6~18 kg。功能性单心室合并肺动脉狭窄9例,室间隔完整的肺动脉闭锁4例,重度三尖瓣下移畸形3例,三尖瓣闭锁3例,矫正型大动脉转位合并右心室流出道狭窄2例,室间隔缺损合并重度三尖瓣狭窄1例。所有患者均在非体外循环下行双向Glenn手术,其中7例行双侧双向Glenn手术。 结果 无手术死亡。术后发生胸腔积液2例,经胸腔穿刺抽液后治愈。术后患者肺动脉平均压13.0±2.3 mm Hg,呼吸机辅助呼吸时间3.0±1.7 h,住院时间9.0±23 d,出院时脉搏血氧饱和度85%±8%,活动耐量明显改善。所有患者均获得随访,随访时间8个月~4年;超声心动图提示:所有患者吻合口通畅,均无扭曲及血栓形成;心功能Ⅰ级18例,Ⅱ级4例。 结论 非体外循环双向Glenn手术治疗小儿复杂先天性心脏病安全,可适当扩大手术适应证。

    Release date:2016-08-30 06:02 Export PDF Favorites Scan
  • The Influence of Cryopreservation on Cellular Viability of Latepregnancy Fetal Valved Allografts in Human

    Abstract: Objective To investigate the influence of cryopreservation on cellular viability of latepregnancy fetal valved allografts in human. Methods The fetal valved allografts with gestational ages ranged from 24 to 40 weeks were sterilely procured within 6 hours after brain death. Each sample was bisected into control group and experiment group. The cellular viability of control group was directly tested and that of experiment group was examined after being storaged in liquid nitrogen for a week through a programmed frozen procedure. The light microscopy, tissue culture and Methylthiazol tetrazolium assay (MTT assay) were used to determine the cellular viability. Results Twelve latepregnancy fetal valved aortic allografts were procured. Light microscopy showed the integrity of the basic structure of the thawed aorta, the normal structure of the collagen and elastic fibers, with part of vascular endothelium lost. There were lots of cells deriving from both groups,but the cellular growing rate of the experiment group was relatively slower. At 490 nm, MTT assay valve of control group was 0.442±0.046, and that of experiment group was 0.424±0.041. The difference between two groups failed to statistically significance(t=1.617, P=0.328). Conclusion There were viable cells in latepregnancy fetal valved allografts after cryopreservation.

    Release date:2016-08-30 06:16 Export PDF Favorites Scan
  • Application of One and A Half Ventricle Repair for Acute Right Ventricular Dysfunction after Biventricular Repair

    Objective To investigate clinical outcomes of one and a half ventricle repair for acute right ventricular dysfunction after biventricular repair. Methods Clinical data of 5 pediatric patients with congenital heart diseases who underwent emergency bidirectional Glenn shunt without cardiopulmonary bypass for acute right ventricular dysfunction after biventricular repair,converting the operation into one and a half ventricle repair,from February 2007 to June 2012 in Qingdao Women and Children Hospital were retrospectively analyzed. There were 4 male patients and 1 female patient with their age of 7-18 months and body weight of 6-13 kg. Preoperative diagnosis included pulmonary atresia with intact ventricular septum (PA/IVS) in 1 patient,tricuspid stenosis (TS) with ventricular septal defect (VSD) and atrial septal defect (ASD) in 2 patients,and tricuspid stenosis with tetralogy of Fallot (TOF) in 2 patients. Postoperative care focused on cardiopulmonary support and control of pulmonary artery pressure. Results Mean pulmonary artery pressure (mPAP) was 12-18 mm Hg at 72 hours after emergency bidirectional Glenn shunt. Mechanical ventilation time was 3-182 hours and ICU stay was 2-13 days. Postoperatively 1 patient died of pulmonary hypertension crisis. The other 4 patients were discharged with their transcutaneous oxygen saturation in the resting state of 93%-99%,which was improved in different degrees compared with preoperative value. These 4 patients were followed up from 6 months to 4 years. Three patients were in NYHA classⅠand 1 patient was in NYHA class Ⅱ during follow-up. Echocardiography showed smooth vena cava to pulmonary artery anastomosis without thrombosis formation. Conclusion One and a half ventricle repair can be used as an adjunct surgical strategy for acute right ventricular dysfunction after biventricular repair.

    Release date:2016-08-30 05:47 Export PDF Favorites Scan
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