83例6个月以下婴儿室间隔缺损的外科治疗  

Surgical treatment of ventricular septal defects:a report of 83 cases

作　　者：李新强[1] 陈海生[2] 钟焕清[2] 钟志敏[2] 陈景伟[2] 余观水[2] 

机构地区：[1]广东医学院 [2]高州市人民医院心血管外科,广东省高州市525200

出　　处：《中国心血管病研究》2006年第11期842-844,共3页Chinese Journal of Cardiovascular Research

摘　　要：目的总结外科手术治疗小婴儿期室间隔缺损(VSD)的临床经验。方法对2000-2005年83例<6月龄VSD患儿,年龄12d至6(4.3±1.2)个月,体重3～6.5(5.1±0.8)kg。膜周部VSD74例,干下型VSD8例,膜周部并肌部VSD1例。术前中、重度肺动脉高压69例(83.1%)。所有患儿均在浅低温体外循环下手术。结果全组手术死亡4例,手术病死率为4.8%。术后主要并发症为肺动脉高压危象、肺部感染和心律失常。结论随着麻醉、体外循环、手术技术和围术期监护处理措施的进步,在小婴儿期施行VSD的外科手术已成为安全的治疗方式。术后对肺高压的处理是手术成功的关键。Objective To review the experience of surgical treatment of ventricular septal defeet（VSD） in infants treated in the recent 6 years. Methods From Jan 2000 to Dee 2005, there were 83 infants less than 6 months old with VSD underwent surgical repair.Their ages ranged from 12 days to 6 months （mean：4.3 months ）.Their body weight ranged from 3.0 -6.5 kg （mean 5.1 kg）.The number of patients with perimem branous VSD was 74,and that of subpulmonary VSD was 8. One patient had multiple VSDs.69 （83.1%） patients had moderate pulmonary hypertension before operation.All patients underwent surgical repair with moderate hypothermia eardiopulmonary bypass. Results Four patients died during their hospitalization making the surgical mortality of 4.8%.The leading postoperative complications were pulmonary hypertensive crisis, pulmonary in feetions and arrhythmia. Conclusion With the standardized and improved method of anaesthesia,CPB,surgieal skill and intensive care, surgical treatment of VSD in infancy is a safe procedure.The key to successful surgery is proper postoperative management of pulmonary hypertension.

关 键 词：室间隔缺损 肺动脉高压 婴儿 新生 

分 类 号：R654.2[医药卫生—外科学]