小儿室间隔缺损1200例外科治疗  

SURGICAL TREATMENT OF VENTRICULAR SEPTAL DEFECT INCHILDREN: A REPORT 1200 CASES

作　　者：张善通[1] 曹金红[1] 陈张根[1] 王人荣[1] 贾兵[1] 邢泉生[1] 李志浩[1] 

机构地区：[1]上海医科大学儿科医院心血管中心

出　　处：《上海医科大学学报》1998年第4期293-295,共3页Journal of Fudan University(Medical Science)

摘　　要：目的探讨小儿先天性心脏病室间隔缺损（室缺）的外科治疗。方法全组１２００例，平均年龄（４．５±２．６）岁。平均体重（１５．５±５．７）ｋｇ。膜部缺损８５９例，干下型缺损３３９例，肌部及左室右房间隔缺损各１例。室缺伴肺高压２２５例，干下型伴主动脉脱垂或关闭不全１０８例，室间隔膜部瘤３１例。缺损直径０．３～３．０ｃｍ。手术切口：右房７２８例，右室１４１例，肺动脉３３１例。缺损直接缝合５０８例，补片修复６９２例。结果手术死亡１３例（１．０８％），其中伴肺高压１２例。死亡原因：低心排综合征５例，呼吸衰竭５例，心律失常、脑部并发症及感染各１例。结论正确诊断、适应证的掌握、手术技术改进、室缺肺高压围术期的处理极为重要。おURPOSE To explore the surgical treatment of ventricular septal defect (VSD) in children.METHODS The open heart operation for closure of VSD was performed on 1200 cases. Their ages were (4.5±2.6) years and weight was (15.5±5.7)kg. The type of VSD. were perimembranous in 859; subarte￣rial in 339; and muscular defect, left ventricle right atrium septal defect in each one case. The dimension of VSD were 0.3～3.0cm. Incision were made on right atrium 728; right ventricle 141; pulmonary artery 331. Direct suture of the VSD in 508 (42.3%) and patch repair in 692 (57.7%). 225 cases were associated with pulmonary hypertension. Aneurysm of membrane septum in 31. According to informations from Echocardiog￣raphy prolapse of the aortic leaflet with aortic insufficiency was present in 225 cases in the type of VSD were subaorterial.RESULTS 13 cases died (1.08%), among those 225 cases associated with pulmonary hypertension 12 cases. Main causes of death were low output syndrome 5; respiration failure 5; arrhythmias, cerebral complication and infection each one case.CONCLUSIONS Proper perioperative management is very important to the surgical treatment for VSD with moderation of severe pulmonary hypertension in infancy.

关 键 词：室间隔缺损 儿童 外科手术 

分 类 号：R726.542[医药卫生—儿科]