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目的比较端侧吻合与人工血管方法矫治婴儿主动脉弓离断术后早、中期疗效。方法婴儿主动脉弓离断矫治手术26例,按手术方式分为端侧吻合组(16例)和人工血管组(10例),随访6~84个月。比较两组患儿术后早、中期的主要疗效。结果人工血管组与端侧吻合组早期疗效比较,差异无统计学意义(P>0.05),其中转流时间分别为(119.3±21.5)分钟和(148.4±56.6)分钟,主动脉阻断时间分别为(65.0±30.1)分钟和(79.4±29.1)分钟,停循环时间分别为(24.3±6.4)分钟和(23.3±13.4)分钟,呼吸机辅助时间分别为(113.1±36.9)小时和(124.3±48.1)小时,重症监护室时间分别为(12.9±6.3)天和(13.0±3.6)天,早期死亡分别为0例和2例,术后早期相关并发症分别为2例和6例。中期疗效比较,差异无统计学意义(P>0.05),其中中期死亡分别为0例和1例,左室流出道梗阻分别为3例和2例,主动脉弓再狭窄分别为3例和1例(重度狭窄),心功能(NYHA)Ⅰ~Ⅱ级分别为10例和9例。结论使用人工血管治疗主动脉弓离断是一种可行的替代方案,特别是对于主动脉弓离断较远时,远期需要进一步干预处理。
Objective To compare the effect of anastomosis of the anastomosis and artificial blood vessels in the treatment of early and midterm aortic arch discectomy after operation. Methods Twenty-six cases of infantile aortic arch surgery were divided into three groups: end-to-side anastomosis group (16 cases) and artificial vascular group (10 cases), followed up for 6 to 84 months. The main efficacy of early and mid-term postoperative complications in both groups were compared. Results There was no significant difference in the early curative effect between the artificial vascular group and the end-to-side anastomosis group (P> 0.05), and the time of the bypass was (119.3 ± 21.5) minutes and (148.4 ± 56.6) minutes, respectively (24.3 ± 6.4) minutes and (23.3 ± 13.4) minutes respectively, ventilator support time was (113.1 ± 36.9) hours and (124.3 ± 48.1) hours, the ICU time was (12.9 ± 6.3) days and (13.0 ± 3.6) days respectively. There were 0 and 2 early deaths respectively. The early postoperative complications were 2 and 6 respectively. There was no significant difference between the two groups (P> 0.05). There were 0 and 1 medium-term deaths, 3 cases and 2 cases of left ventricular outflow tract obstruction, 3 cases of aortic arch restenosis and 1 case of Severe stenosis), cardiac function (NYHA) Ⅰ ~ Ⅱ grade were 10 cases and 9 cases. Conclusion The use of artificial blood vessels in the treatment of aortic arch disconnection is a viable alternative, especially for the aortic arch farther away, the need for further intervention in the long-term.