超声对快速二期大动脉调转术治疗大动脉转位的临床研究

摘要

目的：探讨超声对快速二期大动脉调转术治疗完全性大动脉转位(D-TGA)的临床应用价值.方法：总结分析2005年8月-2011年6月15例施行快速二期大动脉调转术的D-TGA患儿超声心动图表现,比较术前、术中、术后左心室的变化及手术结果,总结分析一期肺动脉环缩术后行二期手术的最佳时机.结果：15例患者一期术后,评估解剖左室,显示室间隔凸向右室面,左心室呈圆形,提示实行二期手术时机已到.二期术后一个月内死亡4例,手术成功率约73.3%.术后3个月随访,1例死于重症肺炎,其余10例主动脉、肺动脉吻合口血流通畅.结论：超声心动图对快速二期大动脉调转术治疗D-TGA的评估手术时机、术中监测以及术后随访均发挥着十分重要的作用.%　　Objective:To evaluate the value of echocardiography in rapid two-stage arterial switch operation for patients with transposition of great arteries(D-TGA).Method:15 patients of D-TGA underwent rapid two-stage arterial switch operation from August 2005 to June 2011.Trace above 15 cases during every phrases of surgery with echocardiography.Result:For 15 cases of rapid two-stage ASO,we could find a left to right bulging of the interventricular when the left ventricule had a circular shape and left ventricule diastolic dimension(LVDD) increased after pulmonary artery banding. Above reminded to two-stage AS0.4 patients died among 1 month after rapid two-stage arterial switch operation.3 months later after operation,1 patient died for lung inflammation.Conclusion:Echocardiography plays an important role in studying ASO during every phrases of surgery.