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目的总结应用非体外循环下双向Glenn手术治疗功能性单心室的经验。方法选取功能性单心室患儿12例,男7例,女5例,年龄7个月-9岁,平均年龄(3.2±1.3)岁;体重5.5-23.0(14.2±2.1)kg;患儿均在非体外循环下行双向Glenn手术。结果本组无手术死亡,无一例需改为体外循环完成手术者,无住院死亡病例。术后患儿肺动脉平均压为(15.2±3.2)mm Hg,呼吸机辅助呼吸时间(6.2±2.1)h,住院时间(9.0±3.1)d,出院时脉搏血氧饱和度(86±9)%,活动耐量明显改善。超声心动图提示:所有患者吻合口通畅,均无扭曲及血栓形成。结论在非体外循环下完成Glenn手术对多数功能性单心室儿童是安全可靠的,可减少术后体外循环并发症。但手术者的技术对获得近期及远期效果有重要作用。
Objective To summarize the experience of using two-way Glenn surgery on off-pump functional heart surgery. Methods Twelve patients with functional single ventricle were selected, including 7 males and 5 females, with a mean age of (3.2 ± 1.3) years and a mean body weight of 5.5-23.0 (14.2 ± 2.1) kg. Children Off-pump bi-directional Glenn surgery. Results There was no surgical death in this group. No patient needed to be converted to surgery under cardiopulmonary bypass. No hospitalized deaths were found. The mean pulmonary artery pressure was (15.2 ± 3.2) mm Hg, ventilator assisted breathing time (6.2 ± 2.1) h, hospital stay (9.0 ± 3.1) days, discharge pulse oxygen saturation (86 ± 9)%, , Significantly improved activity tolerance. Echocardiography Tip: All patients with anastomotic patency, no distortion and thrombosis. Conclusions The Glenn procedure is safe and reliable for most functional single ventricle children without cardiopulmonary bypass, and can reduce postoperative cardiopulmonary bypass complications. However, the technique of the surgeon plays an important role in obtaining immediate and long-term effects.