房室隔缺损的外科治疗  

Surgical treatment of atrioventricular septal defect

作　　者：吴剑[1] 蒋立虹[1] 李亚雄[1] 陈智豫[1] 杨应南[1] 

机构地区：[1]昆明医学院附属延安医院心胸外科,云南昆明650051

出　　处：《云南医药》2010年第1期16-19,共4页Medicine and Pharmacy of Yunnan

基　　金：昆明市科技计划重点项目基金资助;合同编号:昆科计字05S609065(5-1)号;云南省高层次人才培引工程--昆明市延安医院心血管外科治疗技术省创新团队(项目编号:20080C016)

摘　　要：目的房室隔缺损是一种比较多见的复杂先天性心脏病,可分为部分性、完全性和两者之间的过渡性。均能通过手术治疗后达到较好的疗效。方法本文总结我科收治的房室隔缺损病人56例。常规体外循环下进行手术,手术包括二尖瓣裂和房、室间隔缺损的修补;房室瓣返流的纠正及防止房室传导阻滞等。结果42病人心功能恢复到I级,14例II级。50例病人术后二尖瓣轻度返流,54例三尖瓣轻度返流,2例二尖瓣中重度返流。随访近半年,返流较术后早期稍有好转。全组死亡3例。结论我们认为只要有熟悉的解剖知识,加上术者细心的操作和丰富的经验,完全可以避免诸多并发症的发生,使房间隔缺损的外科治疗获得满意的效果及长期生存率。Objective Atrioventricular septal defect is a relatively more common in complex congenital heart disease, which can be divided into partial, complete, and also transitional type between them. After surgical treatment,better effectiveness can be achieved.Methods This paper summarized 56 cases of atrioventricular septal defect in our department between the year 2000 - 2008. By conventional cardiopulmonary bypass, operations had been underwent, including mitral valve cleft repair, atrial and ventricular septal defect repair,and atrioventricular valve regurgitation correction . Prevention of atrioventricular block had been traditionally considered to be very important. In the postoperative follow- up, effectiveness was good . Results The heart function of 42 patients came back to the NYHA I , 14 cases of NYHA II. 50 cases had postoperative mild mitral regurgitation, 54 patients had mild tricuspid valve regurgitation, 2 patients had moderate to severe mitral valve regurgitation. Follow- up of the past six months, regurgitation was slightly improved. In the whole group, 3 patients died. Conclusion We believe that with the anatomy knowledge, careful operation and surgeon experience, a lot of complications can be avoided entirely, so that endocardial cushion defect in a satisfactory surgical results and long- term survival are reasonable.

关 键 词：房室隔缺损 心内膜垫缺损 外科治疗 

分 类 号：R654.2[医药卫生—外科学]