窗透度对长期Fontan结果的影响
Sakura Horie1, Fumiaki Shikata1, Norihiko Oka2
1Department of Cardiac Surgery, The University of Tokyo Hospital, Tokyo, Japan.
概括
在Fontan完成期间的常规化可能会改善长期的结果,特别是减少蛋白质损失性肠病,尽管在一年后的末端透气压力更高. 这支持了在儿科心脏外科手术中创建常规窗口的策略.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 生产性心脏病 手术 手术 生产性心脏病
- 心血管生理学心血管生理学
背景情况:
- 在Fontan完成过程中例行创建一个窗口是旨在稳定早期血液循环的常见外科政策.
- 化通透度对全腔肺连接后患者结局的长期影响仍然是需要研究的领域.
研究的目的:
- 为了评估在Fontan完成过程中创建例行窗口的有效性.
- 检查一年后化通透度对长期结果的影响,包括Fontan相关的肝病和失去蛋白质的肠道病变.
主要方法:
- 在四个机构进行了对105名经过窗口全腔肺连接的患者的回顾性分析.
- 根据1年内窗体状况,患者被分为两组:专利 (F组) 和封闭 (C组).
- 对比了手术前和一年后的导管数据,以及长期并发症,如Fontan相关的肝病和失去蛋白质的肠道病变.
主要成果:
- 虽然1年后的透率与更高的全身腹腔末端透气压 (P=0.007) 相关,但它也与蛋白质损失肠病发病率显著降低 (5.0%对27.0%,P=0.038) 相关.
- 在专利和封闭窗体组之间,没有观察到与Fontan相关的肝病累积发病率的显著差异 (12.5%与9.7%,P=0.69).
- 手术前的血液动力学在各组之间没有差异.
结论:
- 在Fontan完成后的专利化,尽管可能会增加早期的术后心室压力,但通过减少蛋白质损失肠道病变的发生率,可能会产生长期益处.
- 鉴于在手术前难以预测窗透度,常规窗创建的政策似乎是一个有效和有益的外科手术策略.
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