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目的探讨改良Blalock-Taussig分流术(B-T分流术)在肺血减少型先天性心脏病治疗中的临床应用。方法回顾性分析2007年6月至2013年6月期间湖南中医药大学第一附属医院胸心外科共39例肺血减少型先天性心脏病患者行改良B-T分流术的临床资料,其中男23例、女16例,年龄6个月至16岁(4.64±3.85)岁;体重4.5~43.0(14.81±8.69)kg。结果 39例改良B-T分流术后死亡4例,早期死亡3例(术后30 d内),早期死亡率7.69%(3/39)。患者术后动脉血氧饱和度与术前差异有统计学意义(64.28%±8.05%vs.81.07%±5.76%(P<0.01)。随访6个月至6年。28例患者Mc Goon比值(1.11±0.16 vs.1.58±0.22,P<0.01)和Nakata指数[(113.98±14.84)mm2/m2 vs.(160.98±26.65)mm2/m2,P<0.01]均上升,且差异有统计学意义。8例行二期根治手术。结论改良B-T分流术能有效改善患儿缺氧症状,促进肺血管的发育,为二期解剖根治及功能矫治创造条件。
Objective To investigate the clinical application of modified Blalock-Taussig shunt (B-T shunt) in the treatment of pulmonary blood reduced congenital heart disease. Methods The clinical data of 39 patients with pulmonary thrombocytopenia congenital heart disease undergoing thoracic cardiothoracic surgery from June 2007 to June 2013 in our hospital were analyzed retrospectively. Among them, 23 , 16 females, aged 6 months to 16 years old (4.64 ± 3.85) years old; body weight 4.5 ~ 43.0 (14.81 ± 8.69) kg. Results In the 39 cases of modified B-T shunt, 4 died and 3 died early (within 30 days after operation). The early mortality rate was 7.69% (3/39). The arterial oxygen saturation after surgery was significantly different from that before operation (64.28% ± 8.05% vs 81.07% ± 5.76%, P <0.01), followed up from 6 months to 6 years. The Mc Goon ratio 1.11 ± 0.16 vs.1.58 ± 0.22, P <0.01), and the Nakata index [(113.98 ± 14.84) mm2 / m2 vs. (160.98 ± 26.65) mm2 / m2, P <0.01] with statistical significance. 8 routine radical operation.Conclusion Modified BT shunt can effectively improve the symptoms of hypoxia in children and promote pulmonary vascular development for the second stage of dissection and functional correction to create the conditions for treatment.