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目的总结68例中央分流术的应用及随访,探讨中央分流术在复杂先天性心脏病治疗中的应用及效果。方法68例患儿,男36例,女32例,年龄1 d～17岁,体重(9.75±5.83)kg。患儿在不同时期进行了中央分流手术,比较手术前后血氧饱和度的变化。术后进行随访,了解肺动脉发育和后续治疗的情况。结果死亡8例,病死率11.76%。存活患儿症状改善,术后血氧饱和度比术前显著提高(P<0.05)。随访病例肺动脉比术前显著增粗(P<0.05)。26例患儿进行了二次手术,21例为根治手术,5例为再次姑息性手术,2例死亡,再次手术病死率7.7%。结论作为姑息性手术的一种,中央分流术损伤小、操作简单,能改善症状,提高生活质量,为根治手术创造条件。
Objective To summarize the application and follow-up of 68 cases of central shunt to investigate the application and effect of central shunt in the treatment of complex congenital heart disease. Methods 68 cases of children, 36 males and 32 females, aged 1 d ~ 17 years old, weighing (9.75 ± 5.83) kg. The children underwent central shunting at different times and compared changes in oxygen saturation before and after surgery. Follow-up after surgery to understand the development of pulmonary artery and follow-up treatment. Results of death in 8 cases, fatality rate of 11.76%. Survival in children with symptoms improved, postoperative oxygen saturation than before surgery significantly increased (P <0.05). Follow-up of patients with pulmonary artery significantly thicker than before surgery (P <0.05). Twenty-six children underwent second surgery, 21 underwent radical surgery, 5 underwent palliative surgery again, 2 died and re-operative mortality was 7.7%. Conclusion As a palliative surgery, the central shunt injury is small, simple operation, can improve the symptoms and improve the quality of life, to create conditions for radical surgery.