Zellers T M, Driscoll D J, Humes R A, Feldt R H, Puga F J, Danielson G K
Section of Pediatric Cardiology, Mayo Clinic, Rochester, MN 55905.
J Thorac Cardiovasc Surg. 1989 Nov;98(5 Pt 1):725-9.
After the Fontan operation, patients who had a prior Glenn anastomosis should have less pleural drainage than patients without a prior Glenn anastomosis because innominate and pleural vein and thoracic duct pressures are unaltered in the former group. To test this hypothesis, we studied 92 patients who had had a Fontan operation between 1973 and 1986--46 with a prior Glenn anastomosis and 46 without a prior Glenn anastomosis (controls)--who were matched for age, gender, diagnosis, and number of prior shunt operations. The volume of pleural drainage was significantly less (p less than 0.05) in the patients with a prior Glenn anastomosis (median 1,959 ml or 48.2 ml/kg) than in the control patients (median, 3,220 ml or 83.4 ml/kg). Similar results were obtained among the patients matched for prior right thoracotomy (n = 28; 1,270 ml and 2,942 ml; p = 0.028). There was no significant difference between the two groups with respect to ventricular end-diastolic pressure, mean right atrial pressure, mean pulmonary artery pressure, duration of total or differential (right side versus left side) effusion, duration of hospital stay, or hospital or late death.
在Fontan手术之后，既往有Glenn吻合术的患者胸腔引流量应少于无既往Glenn吻合术的患者，因为在前一组患者中无名静脉、胸膜静脉和胸导管压力未改变。为验证这一假设，我们研究了1973年至1986年间接受Fontan手术的92例患者——46例有既往Glenn吻合术，46例无既往Glenn吻合术（对照组）——这些患者在年龄、性别、诊断和既往分流手术次数方面相匹配。有既往Glenn吻合术的患者胸腔引流量（中位数1959 ml或48.2 ml/kg）显著少于对照组患者（中位数3220 ml或83.4 ml/kg）（p<0.05）。在既往有右胸开胸手术的匹配患者中（n = 28；1270 ml和2942 ml；p = 0.028）也得到了类似结果。两组在心室舒张末期压力、平均右心房压力、平均肺动脉压力、总积液或差异积液（右侧与左侧）持续时间、住院时间或住院或晚期死亡方面无显著差异。
