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单心室在姑息治疗前后及矫正手术后的心室容积——分隔手术的概念

Ventricular volume of single ventricle with or without palliation and after corrective surgery--concept of septation procedure.

作者信息

Shimazaki Y, Kawashima Y, Hirose H, Nakano S, Matsuda H, Ogawa M, Morimoto S

出版信息

Jpn Circ J. 1986 Dec;50(12):1209-14. doi: 10.1253/jcj.50.1209.

Abstract

Ventricular volume measurements of single ventricle were carried out in 20 patients with or without palliation and in 2 after total correction. In the former 20 patients, 6 had a single left ventricle and 14 a single right ventricle, anatomically. Two having total correction were associated with undivided ventricle. In the 20 patients with or without palliation, ventricular end-diastolic volume ranged from 64 to 206 (115 +/- 42) percent of the sum of the normal left and right ventricular volumes. Ejection fraction of single ventricle ranged from 0.40 to 0.64 (0.55 +/- 0.06). There was no significant difference in ventricular volume and ejection fraction between patients with a single left and right ventricle. There was high correlation of ventricular volume with pulmonary to systemic blood flow ratio (r = 0.66, p less than 0.005). This indicates that systemic-to-pulmonary shunt should increase ventricular volume of single ventricle. In two patients after total correction, total ventricular volume was 136 and 166% of the sum of the normal left and right ventricular volumes. Total ejection fraction was 0.55 and 0.33 in the first and second patient, respectively. The prosthetic ventricular septum bulged toward the right ventricle during systole and this shift made the left ventricular volume increase and ejection fraction decrease. Right-to-left ventricular volume ratio at end-diastole was 0.74 and 0.67 in the first and second patient, respectively. These results suggest that 1) larger ventricular volume than the sum of the normal left and right ventricular volumes would be required for septation of single ventricle.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

对20例接受或未接受姑息治疗的单心室患者以及2例接受完全矫正手术的患者进行了心室容积测量。在前20例患者中,解剖学上6例为单左心室,14例为单右心室。2例接受完全矫正手术的患者伴有未分隔心室。在这20例接受或未接受姑息治疗的患者中,心室舒张末期容积为正常左、右心室容积之和的64%至206%(115±42%)。单心室的射血分数为0.40至0.64(0.55±0.06)。单左心室和单右心室患者之间的心室容积和射血分数无显著差异。心室容积与肺循环与体循环血流量之比高度相关(r = 0.66,p < 0.005)。这表明体肺分流应会增加单心室的心室容积。在2例接受完全矫正手术的患者中,总心室容积分别为正常左、右心室容积之和的136%和166%。第一例和第二例患者的总射血分数分别为0.55和0.33。人工室间隔在收缩期向右心室凸出,这种移位使左心室容积增加而射血分数降低。舒张末期右心室与左心室容积比在第一例和第二例患者中分别为0.74和0.67。这些结果表明:1)单心室分隔可能需要比正常左、右心室容积之和更大的心室容积。(摘要截短于250字)

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