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目的观察体肺分流联合Glenn手术治疗重度肺血管发育不良紫绀型复杂先天性心脏病(先心病)后肺血管发育情况。方法 41例合并难治性肺动脉发育不良的紫绀型复杂先心病患儿,根据两侧肺动脉发育情况选择体肺分流、Glenn手术等姑息手术方式治疗,观察手术前、后肺动脉指数改变情况。结果术后早期1例死于心跳骤停,其余患者随访6～72个月,手术后两侧平均肺动脉指数(32.60±11.70)较术前(21.81±8.66)明显增高(P<0.05)。结论体肺分流联合Glenn手术等治疗可促进重度肺血管发育不良紫绀型复杂先心病患者双侧肺动脉的发育。
Objective To observe the pulmonary vascular development after pulmonary shunt combined with Glenn’s surgery in patients with severe pulmonary vascular dysplasia of cyanotic complex congenital heart disease (CHD). Methods Forty-one children with cyanotic complex congenital heart disease (CHD) complicated with refractory pulmonary artery dysplasia were treated with palliative surgery such as shunting of lungs and Glenn operation according to the development of bilateral pulmonary arteries. The change of pulmonary index before and after operation was observed. Results One patient died of cardiac arrest in the early postoperative period. The other patients were followed up for 6 to 72 months. The average pulmonary artery index (32.60 ± 11.70) after operation was significantly higher than that before operation (21.81 ± 8.66) (P <0.05). Conclusions Pulmonary shunting combined with Glenn surgery may promote the development of bilateral pulmonary arteries in patients with severe pulmonary vascular dysplasia and cyanotic complex congenital heart disease.