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目的总结采用侧面滑片气管成形技术治疗气管桥合并先天性心脏病和气管狭窄的临床经验。方法回顾性分析我院2010年1月至2015年6月手术治疗8例气管桥合并先天性心脏病和气管狭窄患者的临床资料,其中男3例、女5例,年龄(19.6±9.1)个月;体重(9.9±5.4)kg。其中主气管合并中间段支气管狭窄4例。狭窄段均为完全性气管环或者支气管环。所有患者狭窄直径小于正常50%以上。手术均在同期体外循环下进行先天性心脏病矫治和气管整形。手术技术采用侧面滑片气管成形。结果体外循环时间(64.0±24.1)min。主动脉阻断时间(14.0±18.1)min。无住院死亡。术后平均住院20 d。随访8例,随访时间1个月至5年,术后6周气管肉芽形成1例。其余患者临床症状均明显改善。结论先天性气管桥解剖形态比较特殊,我们采用侧面滑片气管成形技术治疗气管桥合并气管狭窄,取得满意的临床疗效。
Objective To summarize the clinical experience of using lateral vasculoplasty in the treatment of tracheal bridge complicated with congenital heart disease and tracheal stenosis. Methods The clinical data of 8 patients with tracheal bridge complicated with congenital heart disease and tracheal stenosis were retrospectively analyzed from January 2010 to June 2015 in our hospital. There were 3 males and 5 females, and the age was (19.6 ± 9.1) Month; body weight (9.9 ± 5.4) kg. The main tracheal merger in the middle section of bronchial stenosis in 4 cases. Narrow segments are complete tracheal ring or bronchial ring. All patients stenosis diameter less than normal 50%. Surgery were under congenital heart disease during cardiopulmonary bypass and tracheostomy. Surgical technique uses lateral vasculature. Results The cardiopulmonary bypass time (64.0 ± 24.1) min. Aorta blocking time (14.0 ± 18.1) min. No hospital deaths. The average postoperative hospitalization 20 d. Follow-up in 8 cases, follow-up time of 1 month to 5 years, 6 weeks after tracheal granulation formation in 1 case. The remaining patients were significantly improved clinical symptoms. Conclusions The anatomy of congenital tracheal bridge is quite special. We used lateral vasculoplasty to treat tracheal bridge complicated with tracheal stricture, and achieved satisfactory clinical curative effect.