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目的探讨双向格林手术治疗婴儿复杂先心病的临床特点及手术效果。方法选取2006年7月至2014年5月,40例在体外并行循环下行双向格林(Glenn)术的复杂先天性心脏病患儿病例。其中男性23例,女性17例。年龄3个月~1岁,平均年龄(0.73±0.21)岁,体表面积(0.28±0.06)m2。术前经皮血氧饱和度(75±6)%,术前肺动脉压(12.12±3.42)mm Hg。结果全组无死亡,术后出现并发症5例(胸腔积液3例,乳糜胸2例)。术后肺动脉压(18.34±2.52)mm Hg,经皮血氧饱和度(84±7)%。结论对于难以解剖根治或I期Fontan手术的紫绀型肺血减少的复杂先心病患儿,双向Glenn手术是一种简单、可靠的手术方式,可缓解患儿早期的缺氧状况,促进肺血管发育,为二期手术创造了机会。提倡对于难以Ⅰ期根治的复杂先天性心脏病早期干预是安全可行的。
Objective To investigate the clinical features and surgical effects of bi-directional Green surgery in the treatment of infant complicated congenital heart disease. Methods From July 2006 to May 2014, 40 cases of children with complicated congenital heart disease underwent bilateral Glenn surgery in vitro and in parallel. Including 23 males and 17 females. Aged 3 months to 1 year old, mean age (0.73 ± 0.21) years old, body surface area (0.28 ± 0.06) m2. Preoperative percutaneous oxygen saturation (75 ± 6)%, preoperative pulmonary artery pressure (12.12 ± 3.42) mm Hg. Results There was no death in all groups. Complication occurred in 5 cases (pleural effusion in 3 cases and chylothorax in 2 cases). Postoperative pulmonary pressure (18.34 ± 2.52) mm Hg, percutaneous oxygen saturation (84 ± 7)%. Conclusions For patients with complex congenital heart disease who are difficult to dissect or type I Fontan’s surgery in patients with cyanotic pulmonary hypertension, bi-directional Glenn surgery is a simple and reliable surgical approach that can relieve early hypoxia in children and promote pulmonary vascular development , Created the opportunity for the second stage operation. It is safe and feasible to promote early intervention of complicated congenital heart disease which is difficult to cure stage I.