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目的评价大动脉调转术(ASO)手术时机对完全性大动脉转位患儿预后的影响。方法 2008年1月-2009年12月共64例完全性大动脉转位(TGA)患儿在本院行一期ASO,其中36例室间隔完整(IVS),28例并室间隔缺损(VSD)。各组依手术时年龄分为IVS/early组(≤14 d)和IVS/late组(>14 d),VSD/early组(≤28 d)和VSD/late组(>28 d)。回顾性分析各亚组术后围术期并发症及存活情况;随访出院患儿了解其存活情况。结果各亚组患儿在围术期肺动脉狭窄、低心排出量综合征、吻合口出血、创口愈合不良、膈肌麻痹、呼吸道异常、心律失常及呼吸道感染等并发症发生率比较差异均无统计学意义。3例患儿院内死亡,TGA/IVS组及TGA/IVS组2个亚组院内病死率比较差异无统计学意义(TGA/IVS组:8.3%vs0,TGA/VSD组:0vs7.7%,Pa>0.05)。随访13个月,2例患儿院外死亡,TGA/IVS组及TGA/IVS组中2亚组间早期病死率比较差异均无统计学意义(TGA/IVS组:10.5%vs10.0%,TGA/VSD组:0vs22.2%,Pa>0.05)。结论手术年龄不应是影响TGA患儿预后的主要原因,术前机体状态、早产、感染、遵嘱随访是影响TGA患儿预后的重要因素,术前改善机体状态、术后加强随访有助于改善TGA患儿预后,提高其生存率。
Objective To evaluate the effect of aortic transfer surgery (ASO) timing on the prognosis of children with complete aortic transposition. Methods From January 2008 to December 2009, 64 patients with complete aortic transposition (TGA) underwent one-stage ASO in our hospital. Among them, 36 cases had complete ventricular septum (IVS), 28 cases had VSD, . All patients were divided into IVS / early group (≤14 days), IVS / late group (> 14 days), VSD / early group (≤28 days) and VSD / late group (> 28 days) The perioperative complications and survival of each subgroup were retrospectively analyzed. The discharged children were followed up for their survival. Results There was no significant difference in the complication rates of perioperative pulmonary stenosis, low cardiac output syndrome, anastomotic bleeding, wound healing, diaphragmatic paralysis, respiratory abnormality, arrhythmia and respiratory infection significance. There were no significant differences in hospital mortality between the two subgroups of TGA / IVS group and TGA / IVS group (TGA / IVS group: 8.3% vs0, TGA / VSD group: 0 vs. 7.7%, Pa > 0.05). At the 13-month follow-up, 2 patients died of out-of-hospital life, and there was no significant difference in early mortality between the two subgroups in the TGA / IVS group and the TGA / IVS group (TGA / IVS group: 10.5% vs 10.0% / VSD group: 0 vs. 22.2%, Pa> 0.05). Conclusions The operative age should not be the main reason that affects the prognosis of children with TGA. The preoperative body condition, premature delivery, infection and follow-up of follow-up are important factors that affect the prognosis of children with TGA. Preoperative improvement of the status of the body and postoperative follow-up are helpful Improve the prognosis of children with TGA and improve their survival rate.