Casey F A, Craig B G, Mulholland H C
Department of Paediatric Cardiology, Royal Belfast Hospital for Sick Children.
Arch Dis Child. 1994 May;70(5):382-6. doi: 10.1136/adc.70.5.382.
The outcome of surgical palliation was evaluated in 26 children with complex cyanotic congenital heart disease. Outcome was examined in terms of ongoing symptoms, exercise tolerance, and the ability to participate in normal childhood activities. An activity score was calculated and each child performed graded treadmill exercise testing. Breathlessness (24 (92%) children), respiratory infections (nine (35%) children), and leg cramps (eight 31%) children) were the most common physical disorders. Although formal exercise testing showed a clear reduction in exercise tolerance compared with age and sex matched controls, palliation had allowed 23 (89%) to function with moderate exercise limitation, three (11%) having severely limited activity. Parents underestimated the child's exercise tolerance in 80% of cases. Sixteen (62%) patients attended school full time, eight (31%) attended part time, and two (8%) received only home tuition. Palliative surgery can give children with a single functional ventricle a level of activity which allows them to take part in most childhood activities. Subjective estimates of exercise tolerance are inaccurate in this group of children, and formal exercise testing can contribute useful information to decision making about further surgical intervention.
对26例患有复杂性青紫型先天性心脏病的儿童进行了手术姑息治疗效果评估。从持续症状、运动耐量以及参与正常儿童活动的能力方面对治疗效果进行了检查。计算了活动评分，并让每个儿童进行了分级平板运动试验。呼吸急促（24例（92%）儿童）、呼吸道感染（9例（35%）儿童）和腿部痉挛（8例（31%）儿童）是最常见的身体障碍。尽管正式的运动测试显示与年龄和性别匹配的对照组相比运动耐量明显降低，但姑息治疗使23例（89%）儿童在运动受限程度为中度的情况下能够正常生活，3例（11%）儿童的活动严重受限。在80%的情况下，家长低估了孩子的运动耐量。16例（62%）患者全日制上学，8例（31%）患者非全日制上学，2例（8%）患者仅接受家庭教育。姑息性手术可以使单心室功能的儿童达到一定的活动水平，从而能够参与大多数儿童活动。在这组儿童中，对运动耐量的主观估计并不准确，而正式的运动测试可为进一步手术干预的决策提供有用信息。
