ebstein畸形的新进展

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1、SURGICALTREATMENTOFEBSTElN’SMALFORMATION：REPORTOF13CASESSpeciality：CardiovascularSurgeryPostgraduate：WangMingyanTutor：WuShumingZouChengweiAbstract．objecfiveToreviewretrospectivelytheexperienceofsurgical肫8’menfofEbstein’smalformationin13cases·MethodsThirteencaseswithEbstein’sm

2、alformationbeingtreatedwithsu唱eryinDepartmentofCardiovascularSurgery。fShandongprovinci8lHospital疗omJuly1990toDecember2001．LaboratorytestsandassiStantchecksincludingechocardiogram、electrocardiogramandchestx—rayhadbe。ndonebeforesurgery．Heartfunctionshouldbeamelioratedaswellaspo

3、ssiblewithdrugs．ThemainprocedurewasDanielsonoperation·Con。omit8“tDrocedureincludeddivisionoftheabnormalaccessoryconductionpathwayinIpatient．ResuItsTwopatientsdiedearlyaftersurgeryinhospital．Theoverallhospitalmortalitywas15．4％．Thecallsesofdeathwerelowcardiacoutputandacuterenal

4、functionfailure．Thesurvivorsacquiredsubstantialimprovementinheartfunction,whichmostlyimprovedtobeNYHAclass1or11inshort'山东大学硕士学位论文followup．ConclusionsEarlysurgicalinterventionisrecommendedforpatientswithEbstein’smalformation，especiallyforthosewithsymptomsandcardiacenlargement．

5、Tricuspidvalverepairshouldbeperformedifanteriorleafletofthetricuspidvalvewelldeveloped．However．tricuspidvalvereplacementisadvocatedifanteriorleafletisdysplasticoritsorigindisplaceddeeply．KeywordsEbstein’smalformation，cardiacsurgery山尔大学硕十学位论文A。Vnode⋯-·PRoLENE⋯一ASD⋯⋯⋯一PS·······

6、·······TI⋯⋯⋯⋯“CTR⋯⋯一PF0···⋯·····IVS⋯⋯⋯一EF⋯⋯⋯．．符号说明⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯房室结⋯⋯⋯⋯⋯⋯⋯⋯聚丙烯纺织纤维⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯房间隔缺损⋯⋯⋯⋯⋯⋯⋯⋯⋯肺动脉瓣狭窄⋯⋯⋯⋯⋯⋯⋯⋯三尖瓣关闭不全⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯心胸比率⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯卵圆孔未闭⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯’室间隔⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯射血分数4山东火学硕士学位论文13例Ebs-tein畸形的外科治疗专业心血管外科硕士研究生王明岩导师吴树明邹承伟刖舌Ebstein畸形(三尖瓣下移畸形)是一种少见的心脏复杂畸形。由于病变严

7、重程度不同，手术方法上的差别，术后疗效明显不同。本文总结了山东省立医院心血管外科自1990年7月至2001年12月收治的13例Ebstein畸形病人，以进一步探讨其手术适应症、手术方法及预后。山东人学硕十学位论文资料与方法一般资料：本组13例，男7例，女6例；男：女为1．2：l。手术年龄20月～32岁，平均17．6岁。体重15kg～67kg。临床表现：全部病例均有活动后心慌、气急。纳差和腹胀3例，头晕2例，有晕厥史者1例，伴反复阵发性室上性心动过速1例。查体：平静时或活动后紫绀者10例，杵状指(趾)2例。全部病例均可在胸骨左缘2～4肋问闻及II～

8、III级收缩期杂音，闻及三音心律者3例，心前区扪及细震颤者1例，全身浮肿l例(经会诊排除内分泌疾病)，下肢水肿2例。肝肿大4例，可疑腹水