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目的上海儿童医学中心心胸外科数据库采用STS-EACTS数据库颁布的右室双出口(DORV)命名和分类方案后(以下简称为“新方案”),报道该中心外科治疗DORV的新进展。方法2000年5月～2006年5月302例DORV患儿接受手术治疗,根据“新方案”将研究对象分4组,A组:79例,DORV为VSD型;B组:133例,DORV为四联症型;C组:34例,DORV为TGA型;D组:56例,DORV为VSD远离大动脉型。分析“新方案”与DORV手术方法和手术病死率的相关性。结果总病死率7.9%(24/302)。A组和B组的病死率分别为1.3%(1/79)和4.5%(6/133),低于C组(23.5%,8/34)和D组(16.1%,9/56),DORV的新分类方案与住院病死率和手术方法选择有显著的相关性。结论“新方案”有利于数据库对临床资料的搜集和整理,根据“新方案”选择优化的手术方法,可以提高DORV外科疗效。
Purpose The Shanghai Children’s Medical Center’s cardiothoracic surgery database reports new progress of surgical treatment of DORV after adopting the right ventricular dual outlet (DORV) naming and classification scheme (hereinafter referred to as “new scheme”) issued by the STS-EACTS database. Methods From May 2000 to May 2006, 302 children with DORV underwent surgery. According to the “new protocol”, the subjects were divided into four groups: group A: 79 cases, DORV: VSD type; group B: 133 cases, DORV is tetralogy of Fallot; C group: 34 cases, DORV is TGA type; D group: 56 cases, DORV VSD away from the aorta. Analysis of the relationship between the “new protocol” and DORV surgical methods and operative mortality. Results The overall case fatality rate was 7.9% (24/302). The mortality of group A and group B was 1.3% (1/79) and 4.5% (6/133) respectively, lower than that of group C (23.5%, 8/34) and group D (16.1%, 9/56) There was a significant correlation between the new classification scheme of DORV and the choice of hospital mortality and surgical method. Conclusion “new program ” is conducive to the database for clinical data collection and collation, according to “new program ” choose to optimize the surgical methods, can improve the surgical efficacy of DORV.