您现在的位置: 首页> 研究主题> 右室双出口

右室双出口

右室双出口的相关文献在1984年到2021年内共计195篇,主要集中在内科学、外科学、临床医学 等领域,其中期刊论文188篇、会议论文7篇、专利文献512863篇;相关期刊111种,包括中国超声医学杂志、中国医学影像技术、中国医学影像学杂志等; 相关会议7种,包括中国超声医学工程学会第十二届全国超声心动图学术会议、首都医科大学超声科学系第一届超声医学学术大会、2012年十一届全国超声心动图学术会议暨新技术国际研讨会等;右室双出口的相关文献由581位作者贡献,包括徐志伟、苏肇伉、丁文祥等。

右室双出口—发文量

期刊论文>

论文:188 占比:0.04%

会议论文>

论文:7 占比:0.00%

专利文献>

论文:512863 占比:99.96%

总计:513058篇

右室双出口—发文趋势图

右室双出口

-研究学者

  • 徐志伟
  • 苏肇伉
  • 丁文祥
  • 王顺民
  • 刘锦纷
  • 姜冠华
  • 张儒舫
  • 张广福
  • 宋先忠
  • 郑景浩
  • 期刊论文
  • 会议论文
  • 专利文献

搜索

排序:

年份

    • 徐建英; 密凯纳; 徐小薇; 王文媚; 诸纪华
    • 摘要: 总结1例右室双出口患儿术后并发肝素诱导的血小板减少伴血栓形成综合征的护理.护理要点是做好循环功能监测,维持体循环、肺循环稳定及出入量、电解质平衡;做好抗凝剂用药护理及血栓的观察和护理;做好动静脉穿刺护理,加强呼吸道管理.患儿经过52 d的治疗和护理后康复出院.
    • 张秉权; 刘永熙; 邓宇; 曾庆思
    • 摘要: 目的:研究婴幼儿圆锥动脉干畸形合并冠状动脉异位起源各类型发生率、构成比,通过回归分析探讨圆锥动脉干畸形合并冠状动脉脉异位起源的MSCT分类对手术复杂程度的预判能力.方法:回顾性分析520例经手术证实的婴幼儿圆锥动脉干畸形,所有患儿均在广东省妇幼保健院行MSCT心脏成像并记录圆锥动脉干畸形、冠状动脉异位起源类型及数量.对不同类型圆锥动脉干畸形合并冠状动脉异位起源的发生率及构成比分别采用行×列Pearson卡方检验进行比较,使用Logistic回归对手术复杂程度相关指标的预测能力进行分析,与手术结果对照探讨术前MSCT心脏成像诊断对手术复查程度的预测能力.结果:婴幼儿圆锥动脉干畸形共520例,合并冠状动脉异位起源者91例,平均发病率为17.5%,其中肺动脉闭锁(PA)23例,大动脉转位(TGA)27例,法洛氏四联症(TOF)11例,永存动脉干(PTA)9例,右室双出口(DORV)21例.在本组圆锥动脉干畸形合并不同类型冠状动脉异位起源中单冠状动脉(SCA)最多,占61.53%,其次为对侧冠状动脉或无冠窦起源(OO)占23.07%,冠状动脉多发起源(MO)9.89%,冠状动脉高位起源(HO)4.39%,冠状动脉肺动脉起源(PO)最少,占1.09%.采用行×列Pearson卡方检验,卡方值为27.859,P=0.033,说明不同类型圆锥动脉干畸形的冠脉异位起源构成比不全相同即不同类型圆锥动脉干畸形与冠脉异位起源有关联性.本研究冠状动脉异位起源发生率由高到低依次为PTA(39.13%)>TGA(28.12%)>DORV(22.10%)>PA(17.16%)>TOF(6.35%).Logistic回归显示右心室双出口、大动脉转位、对侧冠状动脉或无冠窦起源联合对手术复杂程度有最好的预测效能.结论:圆锥动脉干畸形合并冠状动脉异位起源的MSCT诊断可有效预测手术复杂程度;当心脏MSCT诊断大动脉转位或者右心室双出口时,因涉及动脉调转术而致手术复杂程度增加,如果合并单冠状动脉或对侧冠状动脉异位起源,近端冠状动脉的游离、松解难度增大致动脉调转术中冠状动脉移植失败的风险增加,影响预后;术前必须明确圆锥动脉干畸形类型及伴发冠状动脉异位起源的类型,详细了解冠状动脉起源及其近段走行状态,降低冠状动脉移植风险及改善预后.
    • 李文秀; 方海燕; 耿斌; 杨爽; 吴江
    • 摘要: 目的 探讨S,D,L型解剖矫正型大动脉异位(ACMGA)的产前超声心动图特征,提高本病产前超声诊断准确性.方法 回顾性分析2016年11月至2020年8月经首都医科大学附属北京安贞医院儿童心血管病中心产前超声心动图诊断的S,D,L型ACMGA胎儿的超声心动图特点,总结其超声心动图图像及鉴别要点.结果 共诊断5例胎儿,孕妇年龄26~35(29.4±3.6)岁,孕周23~28(24.2±2.2)周,4例引产(1例尸检),1例出生后经超声心动图、心脏CT及外科手术(肺动脉环缩术)证实.超声心动图特征:①心房正位,心室右襻,房室连接一致;②大动脉平行发自相对应的心室;③主动脉与肺动脉空间位置异常,包绕关系消失,主动脉位于肺动脉左前方;④2条大动脉间可见圆锥肌(主动脉下和/或肺动脉下);⑤主动脉瓣与二尖瓣之间可见主动脉下圆锥肌;⑥肺动脉瓣与三尖瓣之间多无肺动脉下圆锥肌;⑦左室流出道较长,形态似"天鹅颈";⑧常合并室间隔缺损、双侧心耳并置、永存左上腔静脉等心内畸形.结论 产前超声心动图扫查时要严格遵循Van Praagh的节段分析原则,明确每个心脏节段的解剖状况;S,D,L型ACMGA需要与右室双出口进行鉴别诊断.
    • ZHANG Bin-quan; LIU Yong-xi; DENG Ning
    • 摘要: 目的:研究婴幼儿圆锥动脉干畸形合并单支冠脉的类型、发生率、构成比,探讨单支冠脉异位起源MSCT心脏成像诊断对术前计划制定的重要性.方法:回顾性分析421例经手术证实的婴幼儿圆锥动脉干畸形,所有患儿均行MSCT心脏成像,并记录圆锥动脉干畸形的类型、单支冠脉的类型及数量.对不同类型圆锥动脉干畸形合并单支冠脉的发生率及构成比分别采用行×列Pearson卡方检验进行比较.与手术结果对照,探讨术前MSCT心脏成像诊断对术前计划制定的重要性.结果:婴幼儿圆锥动脉干畸形共421例,合并单支冠脉者43例,平均发病率为10.2%,其中肺动脉闭锁PA 11例,大动脉转位TGA 11例,法洛氏四联症TOF 4例,永存动脉干PTA 3例,右室双出口DORV 14例.在本组圆锥动脉干畸形合并单支冠脉中,主动脉与肺动脉间走行(Ⅱb)最多,占51%;其次为走行于右心室圆锥部或肺动脉前(Ⅱa),占28%;单支冠脉起源于右窦(Ⅲ)占14%;单支冠脉远段延续为对侧冠状动脉(Ⅰ)为5%;单支冠脉走行于主动脉根后部(Ⅱp)最少,占2%.对不同的先天性心脏病单支冠状动脉类型构成比行Pearson卡方检验,卡方值为20.805,P=0.186,说明不同类型先天性心脏病的单支冠状动脉类型构成比差异无统计学意义,可以认为不同类型圆锥动脉干畸形合并单支冠脉类型的构成比不全相同,但是Ⅱb型构成比高达51%.本研究单支冠状动脉畸形发生率由高到低依次为DORV(18.4%)>PTA (14.3%)>TGA(13.8%》>PA(10.4%》>TOF(2.9%).结论:不同类型圆锥动脉干畸形合并单支冠脉的发生率及构成比不同,Ⅱb型构成比高达51%,我们应该更多地关注圆锥动脉干畸形合并单支冠脉走行于主动脉与肺动脉间的患儿,尤其是右心双出口类型.
    • 田素英; 孟改玲
    • 摘要: 目的:探讨产前超声心动图在诊断与鉴别诊断胎儿右室双出口中应用价值.方法 :对某院2014年4月~2018年4月期间收治的50例经超声心动图检查发现DORV的胎儿进行超声心动图检查并对比分析产后超声心动图.结果 :对50例胎儿产前产后右室双出口行超声心动图检查,超声心动图呈现患者均出现伴室间隔缺损,引产后尸解发现及产后患儿超声心动图检查误诊为法洛氏四联症和完全性大动脉转位各1例.结论 :产前超声心动图检查可早期发现胎儿右室双出口等发育异常,为妊娠期监护及临床决策提供重要的参考依据.
    • 佟新阳; 甘玲丽; 万峰静; 王根妹; 王康娃
    • 摘要: 目的 探究儿童复杂先心病术后的护理策略.方法 选取本院2018年9月5日收治的单发右位心伴右室双出口及大动脉异位的儿童1例作为研究对象,通过对患儿术后循环系统严密监测、早期应用抗凝药物的护理、呼吸系统的管理、术后早期制定饮食计划及疼痛护理、心理护理,促使其顺利康复出院.结果 术后第1天拔除气管插管转出监护室到普通病房.术后第9天康复出院,血气分析结果正常.结论 予以复杂先心术后患儿具有针对性的护理干预,能有效提高治疗效果,值得在临床推广与应用.
    • 宋杰; 张达雄
    • 摘要: Objective:To investigate the immediate and middle-term outcome of modified Nikaidoh operation for transposition of great arteries (TGA) or double-outlet right ventricle (DORV) with ventricular septal defect (VSD) and pulmonary stenosis (PS).Methods:Thirty-four hospitalized cases who underwent modified Nikaidoh operation in Wuhan Asia Heart Hospital from January.2007 to December.2016 were included in the study.Twenty-two were diagnosed as TGA/VSD/PS,the others were DORV/VSD/PS.The median age at operation was 1.5 years old (3 months to 26 years old) and the median body weight was 11 kg (6 to 42 kg).Results:There were 3 hospital deaths,6 delayed sternal closures and 7 severe complications,which included 3 postoperative hemostasis by thoracotomy,1 complete atrioventricular block,1 medium-size residual shunt in interventricular septum,1 diaphragmatic paralysis and 1 replacement of bovine jugular vein conduit due to severe pulmonary regurgitation.At a median follow-up of 64 months (9 to 115 months),one patient accepted second operation due to PS and right heart failure 8 years after opertion and died,the other 30 cases were all alive and free from reoperation.All cases have cardiac function grade Ⅰ ~ Ⅱ.There was no patient with progressive obstruction of left or right ventricular outflow tract,manifestation of coronary ischemia and over middle degree aortic regurgitation,while 1 case had severe pulmonary regurgitation.Conclusions:Modified Nikaidoh operation for TGA/VSD/PS or DORV/VSD/PS could be the first choice for these kinds of congenital heart disease due to satisfactory mid-term outcome with no increase of perioperatine mortality.%目的:观察改良Nikaidoh术治疗大动脉转位(TGA)或右室双出口(DORV)合并室间隔缺损(VSD)、肺动脉狭窄(PS)的早中期随访结果. 方法:2007年1月至2016年12月在武汉亚洲心脏病医院共行改良Nikaidoh手术34例,其中22例为TGA/VSD/PS,12例为DORV/VSD/PS,患者中位年龄1.5岁(3个月~26岁),中位体质量11 kg (6~42 kg).手术均以改良Nikaidoh术为主要术式. 结果:平均体外循环时间(160±46) min,主动脉阻断时间(119±36) min,重症监护室滞留时间(120±45)h,住院时间(18±11)d.早期死亡3例,延迟关胸6例,严重并发症7例(开胸止血3例、Ⅲ度房室传导阻滞1例、室间隔中等大小残余分流1例、单侧膈肌麻痹1例、因肺动脉瓣严重反流而置换牛颈静脉管道1例).随访中位时间64个月(9~115个月),1例因PS、右心衰竭于术后第8年再次手术后死亡;其余30例均未行二次手术,临床心功能Ⅰ~Ⅱ级,无左、右室流出道进行性梗阻病例,无冠状动脉缺血表现,无中度以上主动脉瓣反流,1例肺动脉瓣重度反流. 结论:改良Nikaidoh术治疗合并VSD和PS的心室大动脉连接异常,并不增加围术期死亡率,中期随访效果满意,可作为首选术式.
    • 赵力运; 范太兵; 李斌; 周司杰; 胡曼曼
    • 摘要: 目的:评估3D打印心脏模型在右室双出口术前评估及手术方案制定中的应用价值.方法:收集2016年3~12月收治的右室双出口患者12例(男3例、女9例)的CT血管造影资料,应用3D打印技术制作心脏模型,比较3D打印心脏模型与术中探查结果的符合程度.结果与结论:3D打印心脏模型可精确显示心脏空间结构,与术中探查符合度高,能够很好地显示主动脉与肺动脉的结构关系、室间隔缺损(VSD)与大动脉的位置、VSD与肺动脉瓣的距离等,可在模型上评估是否可行双心室矫治,并可评估双心室矫治患者内隧道的形态、位置,有利于术中内隧道的建立.3D打印心脏模型有利于右室双出口患者的术前评估和手术方案的制定.%Aim: To evaluate the clinical value of three-dimensional(3D) printed model in preoperative assessment and surgical planning of double outlet right ventricle(DORV).Methods: Form March to December 2016, twelve patients (3 males and 9 females) with DORV were collected. The 3D printed cardiac models were created by 3D printing technology and the clinical value of 3D printed cardiac models in surgical strategies was assessed in patients with DORV by comparing the information from 3D printed cardiac models and intraoperative exploration. Results and Conclusion:There was good conformity between 3D printed cardiac models and intraoperative exploration. The relationship between the aorta and the pulmonary artery,the location of the ventricular septal defect(VSD) and the distance between the VSD and the pulmonary artery valve were precisely demonstrated in 3D printed cardiac models. The model could be used to assess whether it was feasible for biventricular repair as well as assess the shape and location of the intracardiac tunnel in biventricular repair pa-tients,which was favorable for the formation of the tunnel. It is expected to use 3D printed cardiac models to provide preop-erative assessment and surgical planning.
    • 陈小龙; 沈立; 任璐璐; 龚瑾; 谢业伟; 李小兵; 单兴; 李佳; 张儒舫
    • 摘要: 目的 总结儿童右室双出口的外科治疗体会.方法 2009年2月至2017年3月共手术治疗87例患儿,男性48例,女性39例,年龄10 d至18岁,平均(30.0±44.4)个月,体重3.17~47(11.1±8.8)kg.根据STS-EACTS数据库分类:VSD型43例,TOF型7例,TGA型9例,VSD远离大动脉型28例.共经历手术100例次,非体外循环下手术30例次,体外循环下手术70例次.体外循环时间32~234(103.3±49.3)min,主动脉阻断时间12~180(59.6±37.2)min.VSD型手术方法包括心室内隧道补片修补33例,PA Banding术5例,B-T分流术1例,双向Glenn术7例,改良Fontan术1例,术后出现右心室流出道狭窄行右心室流出道重建术3例.TOF型手术方法为心室内隧道补片修补+右室流出道疏通术.TGA型手术方法均为大动脉调转术,同期行IAA(A)矫治术1例,术后出现右心室流出道狭窄行右心室流出道重建术4例.VSD远离大动脉型手术方法包括B-T分流术4例,PA Banding术5例,双向Glenn术17例,改良Fontan术4例.术后呼吸机时间4~360(46.4±60.6)h,监护室时间6h至21 d,平均(127.2±81.6)h,住院时间11~39(23.3±12.1)d.结果 100例次手术术后呼吸机时间平均(46.4±60.6)h,监护室时间平均(127.2±81.6)h,住院时间平均(23.3±12.1)d.84例患儿顺利存活.住院死亡3例,手术死亡率3%,1例B-T分流术后低氧血症,1例术后低心排综合征,1例术后心功能不全、肾功能不全及肝功能不全,经腹透及血液滤过治疗后并发颅内出血伴昏迷,家长要求放弃治疗而死亡.其余患儿效果良好.随访12个月至5年,无晚期死亡病例.结论 DORV疾病谱广,病种复杂,术前需充分评估病情,根据患儿的解剖特点和年龄制订个体化的手术方案,可以获得比较满意的手术效果.%Objective To explore surgical treatment experience of double outlet right ventricle in children.Methods From February 2009 to March 2017,87 patients with DORV underwent surgical repair at this center.Among the 87 patients,48 were males and 39 were females.There ages ranged from 10 days to 18 years old,mean age (30.0±44.4)months.Their weight ranged from 3.17-47 kg (11.1±8.8)kg.According to STS-EACTS international nomenclature:43 patients were DORV associated with ventricular septal defect (VSD),7 were DORV with tetralogy of Fallot (TOF),9 were DORV with transposition of the great arteries (TGA),and 28 were DORV with remote VSD.Total surgery times were 100,70 cases underwent extracorporeal circulation,the extracorporeal circulation time ranged from 32-234 (103.3±49.3)minutes,the aorta blocking time ranged from 12-180 (59.6± 37.2)minutes.30 cases were underwent non extracorporeal circulation.The surgical methods of DORV associated with ventricular septal defect(VSD) including the heart tunnel patch repair in 33 cases;the PA Banding operation in 5 cases;the B-T bypass operation in 1 case;the bidirectional Glenn operation in 7 cases;the Modified Fontan operation in 1 case;ventricle outflow tract reconstruction after surgery in 3 cases.The surgical methods of DORV with tetralogy of Fallot(TOF) were heart tunnel patch repair plus ventricle outflow tract reconstruction.The surgical method of DORV with transposition of the great arteries(TGA) was switch surgery,1 case underwent IAA (A) surgical rectifying at the same time,ventricle outflow tract reconstruction after surgery in 4 cases.The surgical methods of DORV with remote VSD including B-T bypass operation in 4 cases;the PA Banding operation in 5 cases;the bidirectional Glenn operation in 17 cases;the modified Fontan operation in 4 cases.The Postoperative respiratory machine time ranged from 4-360 (46.4±60.6)hours,the time in CICU ranged from 6 hours to 21 days,mean time(127.2±81.6)hours,the discharge time ranged from 11-39(23.3±12.1)days.Results Of the 100 cases,the postoperative respiratory machine time ranged from 4-360 (46.4±60.6)hours,the time in CICU ranged from 6 hours to 21 days,mean time(127.2±81.6)hours,the discharge time ranged from 11-39(23.3±12.1)days.84 cases were survived,3 patients died after surgery,the operation mortality is 3%.1 case underwent hypoxemia after B-T bypass operation;1 case underwent low cardiac output syndrome postoperative;1 case underwent cardiac insufficiency,renal insufficiency,and hepatic insufficiency postoperative,raised intracranial hemorrhage and coma after treatment of peritoneal dialysis and hemofiltration,the parents requested treatment and die.The rest of the patients with good effect,follow up for 12 months to 5 years,no late deaths.Concltsion DORV has numerous of ariations and complexity,need to fully evaluate the condition preoperative,to formulate individual operation plan according to the anatomical characteristics and the age of the patients,it can obtain satisfactory surgery results.
  • 查看更多

客服邮箱:kefu@zhangqiaokeyan.com

京公网安备:11010802029741号 ICP备案号:京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有
  • 客服微信

  • 服务号