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[大动脉转位的解剖学矫正。对首批50例手术患者的思考及手术选择分析]

[Anatomical correction of transposition of great vessels. Considerations on the first 50 patients operated on and analysis of the surgical choice].

作者信息

Pozzi M, Fuchs M, Urban A

机构信息

Reparto di Cardiochirurgia Pediatrica Kinderklinik, Sankt Augustin, Germania Federale.

出版信息

G Ital Cardiol. 1990 Dec;20(12):1125-9.

PMID:2083808
Abstract

After having adopted the arterial switch operation as an alternative to the Mustard operation we decided to review our results with this protocol in order to evaluate the validity of our choice. From June 1984 to Oct. 1989 a total of 50 patients underwent an arterial switch operation in our department: 36 (72%) with simple transposition of the great arteries and an essentially intact ventricular septum; 9 (18%) with transposition of the great arteries and ventricular septal defect and 5 (10%) with the Taussing-Bing anomaly. In the group with simple transposition, the age ranged between 3 and 24 days (mean 8.7 +/- 4.3 S.D.) and the weight was between 2.4 and 4.9 kg (mean: 3.46 +/- 0.42 S.D.). In the group with transposition of the great arteries and ventricular septal defect the age ranged between 7 and 690 days (mean: 194 +/- 206 S.) and the weight was between 3.1 and 9.7 kg (mean 6 +/- 2.34 S.D.). In the group with Taussig-Bing anomaly the age ranged between 9 and 216 days (means: 132 +/- 75 S.D.) and the weight was between 3.2 and 5.1 kg (mean: 4.1 +/- 0.75 S.D.). A balloon atrial septostomy was performed in 43 (86%) patients. The Lecompte manoeuvre was adopted in 49 (98%) patients. The total early mortality was 10% (5/50). In the 36 neonates with simple transposition of the great arteries, 4 (11.1%) died. Among the 14 patients with transposition of the great arteries and ventricular septal defect and Taussig-Bing anomaly there was 1 (7.1%) death. There was also 1 (2.2%) late death.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

在采用动脉调转手术替代Mustard手术之后,我们决定回顾采用该术式的结果,以评估我们选择的合理性。从1984年6月至1989年10月,我们科室共有50例患者接受了动脉调转手术:36例(72%)为单纯大动脉转位且室间隔基本完整;9例(18%)为大动脉转位合并室间隔缺损;5例(10%)为陶西格-宾(Taussig-Bing)畸形。在单纯大动脉转位组,年龄范围为3至24天(平均8.7±4.3标准差),体重为2.4至4.9千克(平均:3.46±0.42标准差)。在大动脉转位合并室间隔缺损组,年龄范围为7至690天(平均:194±206标准差),体重为3.1至9.7千克(平均6±2.34标准差)。在陶西格-宾畸形组,年龄范围为9至216天(平均:132±75标准差),体重为3.2至5.1千克(平均:4.1±0.75标准差)。43例(86%)患者进行了球囊房间隔造口术。49例(98%)患者采用了Lecompte手法。早期总死亡率为10%(5/50)。在36例单纯大动脉转位的新生儿中,4例(11.1%)死亡。在14例大动脉转位合并室间隔缺损及陶西格-宾畸形的患者中有1例(7.1%)死亡。还有1例(2.2%)晚期死亡。(摘要截选至250字)

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