1381例先天性室间隔缺损的外科治疗  

The surgical treatment of congenital ventricular septal defect in 1381 patients

作　　者：刘志红[1] 姬尚义[1] 杨建安[1] 陈长春[1] 

机构地区：[1]深圳市孙逸仙心血管医院外科,广东省深圳市518020

出　　处：《中国心血管病研究》2006年第6期409-411,共3页Chinese Journal of Cardiovascular Research

摘　　要：目的总结先天性室间隔缺损(VSD)手术治疗的临床经验。方法1992年12月至2005年10月手术治疗VSD1381例,男性835例,女性546例,年龄2天至55岁,平均(4.6±3.2)岁。体重2.5～80(14.5±10.7)kg,<10kg者487例(35.3%)。均在低温体外循环下手术,必要时应用深低温低流量及改良超滤技术。直视缝合823例,补片修补558例。结果术后30d内死亡24例(其中11例年龄<6个月),死亡率1.74%;晚期死亡1例。主要并发症发生率9.7%。结论手术治疗室间隔缺损效果满意。但<6个月龄的低体重婴儿应严格控制手术适应证。干下型VSD应早期手术,防止主动脉瓣关闭不全的发生。术后应重视对呼吸系统、循环系统的监护与治疗。Objective To review the clinical experience of the surgical treatment of congenital ventricular septal defect （VSD）. Methods From Dec .1992 to Oct. 2005, 1381 patients （835 males, 546 females ）were operated on for their VSD. The patients＇ age ranged from 2 days to 55 years old （4.6±3.2 years old）. The body weight ranged from 2.5 to 80 kg（14.5±10.7）kg. 487 eases were less than 10 kg （35.3%）. All patients underwent VSD repair under hypothermic anaesthesia with cardiopulmonary bypass. If necessary, deep hypothermic and low flow or improved superfilter was used. 823 cases were repaired with direct stitch closure and 558 with patch closure. Results There were 24 deaths （10 infants younger than 6 months, one new born） and operative mortality was 1.7% One infant died 66 days after operation. The morbidity was 9.7%. Conclusions VSD is the most common congenital heart disease and operative treatment may got satisfactory result while indication of infants who are younger than 6 months must be control strictly. Subpulmonary VSD should be repaired early to prevent aortic insufficiency. The care and therapy of the respiratory and circulatory system must be emphasized after operation. The treatment of perioperarive pulmonary hypertension must be highlighted.

关 键 词：室间隔缺损 先天性 手术治疗 

分 类 号：R654.2[医药卫生—外科学]