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目的 探讨全腔静脉肺动脉连接术治疗儿童复杂先心病的方法及疗效。方法 年龄0.5~11.5岁的复杂先天性心脏病患儿(单心室伴其他畸形5 例, 右室双出口伴其他畸形3 例,三尖瓣闭锁2例,三尖瓣下移畸形1例) 11例施行了心外管道或房内侧壁隧道全腔静脉肺动脉连接术,采用自体心包6例,采用Gore Tex管道连接5例, 11例中开窗5 例。结果 全组死亡1 例, 术后患儿血氧饱和度由65%~85%增加至92%~96%, 运动耐力明显增强, 心脏容量负荷减轻, 血流动力学满意,近期疗效较好。结论 全腔静脉肺动脉连接术操作简捷, 血流动力学满意,能有效提高患儿血氧饱和度及减轻心脏容量负荷。术后并发症和病死率较低。
Objective To investigate the method and effect of total cavopulmonary connection in children complicated with congenital heart disease. Methods Children with complicated congenital heart disease (single ventricle with other deformities in 5 cases, right ventricular double outlet with other deformities in 3, tricuspid atresia in 2 and tricuspid regurgitation in 1 to 11 years old) Cases of extracardiac or intra-atrial tunnel tunnel total cavopulmonary connection, the use of autologous pericardium in 6 cases, the use of Gore Tex duct connection in 5 cases, 11 cases of window in 5 cases. Results One patient died in the whole group. The oxygen saturation increased from 65% ~ 85% to 92% ~ 96% after operation. The exercise tolerance was significantly increased, the cardiac capacity was relieved, and the hemodynamics was satisfactory. Conclusions Total cavopulmonary connection is simple, hemodynamic satisfactory, can effectively improve the oxygen saturation of children and reduce the cardiac capacity load. Postoperative complications and mortality were lower.