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为提高双腔右心室(DCRV)的术前诊断率和手术安全性,作者回顾分析了10年间外科诊治DCRV32例的经验,其中单纯DCRV9例,合并畸形23例。21例小于7岁的患儿术前心电图16例示T_(V_1、V_(3R))直立,且aVR导联与右心前V_(3R)、V_1导联R波高大不对称。17例右心导管检查11例测得右心腔内存在的压力阶差>3.33 kPa,但2岁以下患儿压力阶差不明显。10例右室造影9例显示右室腔内充盈缺损。术中适当切除异常肥厚肌束,采用自体心包补片修补室缺,疗效满意。认为DCRV为一独立的心内畸形,且随年龄增大而病情加重;一旦确诊,应尽早手术为宜。
To improve the preoperative diagnosis rate and surgical safety of double-chamber right ventricle (DCRV), the author retrospectively analyzed the experience of surgically treating 32 cases of DCRV in 10 years, including 9 cases of DCRV alone and 23 cases of deformity. There were 16 cases of T_ (V_1, V_ (3R)) in 21 cases less than 7 years old, and the aVR lead was not symmetrical with the R_ waves of V_ (3R) and V_1 leads. In 17 cases of right heart catheterization, pressure gradient of> 3.33 kPa was found in right heart cavity, but pressure gradient was not obvious in children under 2 years old. Right ventricular angiography in 10 cases 9 cases showed right ventricular filling defect. Intraoperative appropriate removal of abnormal hypertrophic muscle bundle, the use of self-pericardial patch ventricular fill, the effect is satisfactory. That DCRV is an independent heart deformity, and aggravate with age; once diagnosed, surgery should be as soon as possible.