辅助肺血流对双向格伦手术后生存的影响
R D Mainwaring1, J J Lamberti, K Uzark
1Cardiac Institute, Children's Hospital-San Diego, San Diego, CA, USA. rmainwar@nemours.org
Circulation
|November 24, 1999
概括
在双向格伦手术 (BDG) 期间消除辅助肺血流 (APBF) 可能会改善功能单心室患者的长期存活率. 这项研究发现,在没有APBF的患者中,手术后和晚期死亡率较低.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 生产性心脏手术 手术 生产心脏手术
- 心血管生理学心血管生理学
背景情况:
- 双向格伦手术 (BDG) 是单心室生理学手术缓解的一个关键步骤.
- 关于在BDG期间管理辅助性肺血流 (APBF) 的临床辩论存在.
- APBF可能会增加全身和,但也会增加心室的体积负荷.
研究的目的:
- 研究辅助肺血流 (APBF) 在双向格伦手术 (BDG) 后对生存率的影响.
- 确定消除APBF是否会影响功能单心室管理中的患者结果.
主要方法:
- 在1986年至1998年期间接受BDG治疗的149名患者的回顾性审查.
- 与APBF消除患者 (n=93) 和APBF患者 (n=56) 之间的结果比较.
- 使用卡普兰-梅尔曲线进行精算分析,包括后续丰田完成的风险.
主要成果:
- 没有APBF的手术死亡率为2.2%,与APBF相比为5.4%.
- 晚期死亡率与APBF (15.1%) 相比,与其消除 (4.4%) 相比,显著更高.
- 卡普兰-梅尔生存分析显示,没有APBF的患者显著受益 (P<0.02).
结论:
- 在BDG时消除APBF似乎提供了长期的生存优势.
- 这一发现支持在单心室息治疗中减少心室体积负荷的策略.
- 进一步的研究可能会完善BDG中APBF管理的指示.
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