改良blalocktaussig分流术治疗复杂先天性心脏病与随访的研究

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1、复11人学破I学位论文改良BlalockTaussig分流术治疗复杂先天性心脏病及陌访研究改善缺氧，挽救患儿生命；远期则可以促进肺血管的发育，为二期手术创造条件：手术操作技术及围手术期处理是取得良好手术效果，减少手术死亡率及术后并发症的关键。关键词：改良Blalock—Taussig分流术：心脏缺损，先天性；膨体聚四氟乙烯人造血管(PTFE)，R72复口人学顿lj学位论文改良Blalock—Taussig分流术治疗复杂先天性心脏病及随访研究ApplicationofmodifiedBlalock——Taussigshuntsinp

2、atientswithcomplexcongenitalheartmalformationsandoutcomeoffollow-upAbstractOgj『ECTIgE：ThemodifledBlalock—Taussigshunt(MBTS)iSconsidereda10W—riskmanagementoptionforpal1iaLioninpatientswithseverelycyanotiCheartanomaliesinadvancedheartcentersinwesterncountries．Butthemorb

3、id]tyandmortalityassociatedwithMBTSremainschallengeindevelopingcountr]es．METHODS：32patientswithseverelYcyanotiCcomplexheartanomaliesunderwent37modifiedBlalock—Taussigshunts(MBTS)inourhospitalbetweenOctober2000andDecember2005．Themeanagewas3．8±1．im(1d一37．2m)．Themeanwe]g

4、htofthebabieswas5．0±2．1kg(2．3kg～12．0kg)．ThecardiacanatomyWasasfollows：pulmonaryatresiawithintactventriCUlarseptumin3，pu]monaryatresiawithventFiCUIarseptumdefectsin14，tricuspidatresiain4，tetralogyofFallotin3，complexsingleventriclephysiologyin4，transpositionoflgreatarte

5、rywithpulmonarystenosiSin3，andtranspositionofgreatarterywith1eftventrieularma]developmentjn1．A1lpatientsweredeep]YcyanotiC，andpreoperativeprostaglandinE1WaSneededin20patientStoensureductuspatentandmaintainoxygensaturationspriortotheshuntoperation．Theshuntswereaccompli

6、shedwith3．0m瑚po]ytetrafluoroethylenegraftsin2patients，：j．5mmin6，4mmin16，5mmin8and6mmin4．RESULTS：Themeandurationofmechanicalventilationwas1．8±2．8days(4h一5d)．ThemeancardiacintensivecareunitstayWaS6．2±8．5d(2d—12d)．Themeanhospitalstaywasi0．7±8．7d(7d一18d)．Therewere3deaths(

7、9．4％)，doubtedimmediatepost—operativeshuntblockin1，severehypoxidosiSin1andsuddendeathin1．Oxygensaturationincreasedfrom60．5％preoperativelYto78．3％postoperatively．Fourpatientshadshunlblerr，additionalshuntwascreatedrespecLivelY．Therewasllatedeath．墨垦查兰竺!：兰垡兰茎墼垦!!!!竺!：!兰!!!!

8、!坌窭查塑堡星墨堑茎堕塑墅墅塑塑i堡!墨F01low-upof22patients(3—41m．mean：5．8±8．5m)revealedsatisfactorysystemicoxygensaturationof77±13％(45～95％)-C