新生儿完全性肺静脉异位引流的外科治疗及效果分析
投稿时间:2016-12-01  修订日期:2016-12-12  点此下载全文
引用本文:张金涛,李群.新生儿完全性肺静脉异位引流的外科治疗及效果分析[J].医学研究杂志,2017,46(8):100-102
DOI: 10.11969/j.issn.1673-548X.2017.08.025
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作者单位E-mail
张金涛 450052 郑州大学第三附属医院心脏中心  
李群 450052 郑州大学第三附属医院心脏中心 henanli943@163.com 
基金项目:河南省高等学校重点科研基金资助项目(14B320029)
中文摘要:目的 评价完全性肺静脉移位引流患儿在新生儿期实施手术的效果,分析手术的危险因素。方法 收集笔者医院自2010年6月~2016年6月实施肺静脉移位引流纠治手术的新生儿21例,其中男性15例(71%),女性6例(29%),年龄中位数为20天,体重中位数为3.5kg,其中心上型10例,心内型6例,心下型4例,混合型1例;用Logistic回归方法对可能导致手术死亡的因素进行分析。结果 住院死亡4例(19%),心上型1例,心内型1例,心下型2例;2例死于低心排,2例死于肺部感染;Logistic回归分析发现,术前肺部感染、解剖分型、主动脉阻断时间、体重分级为影响手术后治疗效果的危险因素。结论 完全性肺静脉移位引流患儿在新生儿期实施手术治疗,可以取得比较满意的效果,术前肺部感染、解剖分型、主动脉阻断时间、体重分级是影响手术效果的危险因素。
中文关键词:完全性肺静脉异位引流  新生儿  外科手术
 
Risk Factors of Total Anomalous Pulmonary Venous Connection Operation in Neonates
Abstract:Objective To summarize the experience of surgical of complete pulmonary venous connection in neonates, and analyze the risk factors. Methods Between June 2010 to June 2016, 21 consecutive neonates under went surgical correction of total anomalous pulmonary venous connection. There were 15 males and 6 females at mean age 20d, and the mean weight was 3.5kg. There were 10 patients with supracardiac, of which 6 patients with intracardiac, 4 patients with infracardiac, and 1 patients with mixed. Clinical variables possibly associated with death were examined using Logistic regression analysis. Results There were 4 operative deaths(19%),2 patients with supracardiac, 1 patient with intracardiac, 1 patient with infracardiac. 2 were died of low cardiac output syndrome, and 2 died of pneumonia. Logistic regression analysis showed that preoperative pulmonary infection, anatomic classification, aortic clamping time, weight were risk factors of operation. Conclusion Total anomalous pulmonary venous connection operation in neonates can obtain satisfactory results. Preoperative pulmonary infection, anatomic classification, aortic clamping time, weight are risk factors for operation.
keywords:Total anomalous pulmonary venous connection  Neonate  Surgery
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