668例婴幼儿室间隔缺损的手术治疗

目的：探讨近5年间外科手术治疗婴幼儿期室间隔缺损(VSD)的结果和经验。方法：对1998--2002年的668例婴幼儿VSD修补术进行总结：年龄1～36个月(平均15-8个月)，体重3．0～15．5k(平均8．1kg)。膜周部VSD 562例，干下型VSD 102例．膜周部并肌部VSD4例。术前中度以上肺动脉高压386例(57．8％)。因难治性肺炎或心衰而急诊手术89例(13．3％)。采用中度低温体外循环下手术。结果:全组手术死亡6例，手术病死率为0．9％(6／668)：术后主要并发症为肺部感染、心律失常和肺动脉高压症。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，在婴幼儿期施行室间隔缺损的外科手术已成为安全的治疗方式。

Surgical treatment of ventricular septal defects:a reporl of 668 cases

Objective To review the experience of Surgical treatment of ventricular septal defect (VSD) in infants treated in the recent 5 years. Methods From Jan 1998 to Dec 2002,there were 668 infants less than 3 years old with VSD underwent surgical repair. Their ages ranged from 1 to 36 months (mean: 15.8 months). Their body weight ranged from 3.0 to 15.5 ?kg (mean 8.1 ?kg). The number of patients with perimem branous VSD was 562,and that of subpulmonary VSD was 102. Four patients had multiple VSDs. 386 ( 57.8% ) patients had moderate or severe pulmonary hypertension before operation. 89( 13.3% ) underwent emergency operation because of respiratory failure or congestive heart failure. All patients underwent surgical repair with moderate hypothermia cardiopulmonary bypass. Results Six patients died during their hospitalization making the surgical mortality of 0.9% . The leading postoperative complications were pulmonary infections,arrythmia and pulmonary hypertensive crisis. Conclusions With the standarized and improved method of anaesthesia,CPB,surgical skill and intensive care,surgical treatment of VSD in infancy is a safe procedure.