双向空腔肺连接患者的血液动力学结果与额外或前级肺血流:单中心回顾性研究
Kernfan Puthikitakawiwong1, Chodchanok Vijarnsorn1, Teerapong Tocharoenchok2
1Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
PeerJ
|October 13, 2025
概括
双向腔肺连接 (BCPC) 与额外的前级肺血流 (AAPBF) 显著增强单心室患者的肺动脉生长. 这种方法优化了肺动脉的发育,而不会对血液动力学或生存率产生负面影响.
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
- 血液动力学 血液动力学
背景情况:
- 双向腔肺连接 (BCPC) 是单心室患者的关键手术步骤.
- 在BCPC期间,额外的前级肺血流 (AAPBF) 的作用对于优化随后的全腔肺连接 (TCPC) 进行了辩论.
研究的目的:
- 评估BCPC与AAPBF对肺动脉生长的影响.
- 评估BCPC与AAPBF对单心室患者血液动力学结果的影响.
主要方法:
- 对接受BCPC的167名单心室患者的回顾性分析.
- 患者被分为两组:有AAPBF (n=44) 和没有AAPBF (n=123).
- 在BCPC前后的肺动脉生长 (麦高恩比率,纳卡塔指数,z-scores) 和血液动力学参数 (mPAP,EDP,PVRi) 的比较.
主要成果:
- 患有AAPBF的患者表现出右和左肺动脉大小显著增加 (p=0.019,p=0.004).
- 纳卡塔指数随着AAPBF的增加而增加,但没有它就下降了 (p<0.001).
- 在BCPC前,小组之间没有观察到肺动脉平均压力,终端透气压力或指数化肺血管阻力之间的显著差异.
结论:
- 与AAPBF一起的BCPC促进了显著的肺动脉生长.
- AAPBF不会对心室体积负荷或肺动脉压力产生不利影响.
- 建议对动脉静脉形发展进行进一步的研究.
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