新生儿先天性心脏病临床特点分析

目的：探讨新生儿先天性心脏病（先心病）的临床特点。方法：对１２３例新生儿的临床表现、心脏超声及心电图进行分析。结果：新生儿先心病类型复杂，心衰２１例（１７１％），早期闻及心脏杂音７９例（６４２％），青紫３２例（２６０％），心音增强或减弱１１例（８９％），心律失常６例（４９％），死亡２７例（２２０％）。结论：新生儿先心病除心脏杂音外，青紫、心衰、心音异常及心律失常为重要体征，可疑病例应尽早作超声检查，明确诊断，指导治疗。     

新生儿先天性心脏病的彩色多普勒超声诊断及分析

目的：研究新生儿先天性心脏病的类型及临床特点。方法：对1995－2001年61例新生儿先天性心脏病的彩色多普勒超声波特点进行分析，并随访4例紫绀型先心病，12例非青紫型先心病患儿3个月至7年。结果：非青紫型先心病40例（65．6％）最常见类型为室间隔缺损（31．1％），动脉导管未闭（18．0％），房间隔缺损（6．6％），肺动脉瓣狭窄（1．6％）；青紫型21例（34．4％）中大动脉转位位居第一（11．5％），第二位为法乐氏四联征（8．2％），单心室（6．6％），居第三位。经胎儿超声心动图产前诊断先心病2例，1例为室间隔缺损，1例为单心室，新生儿先心病的临床表现主要为心脏杂音（82．0％），气促（62．3％）,持续性青紫（34．4％）。随访紫绀型先心4例，均手术治疗，2例术后死亡；非青紫型患儿12例，自愈7例，3例手术矫正，2例未愈无并发症。结论：为控制先心病胎儿的出生，降低婴幼儿的死亡率，应重视先心病的产前诊断并对重症患者终止妊娠，先后宜尽早行彩色多普勒超声检查以确诊。     

球囊瓣膜成形术治疗94例小儿先天性肺动脉瓣狭窄

肺动脉瓣狭窄（ＰＳ）发生率约占小儿先天性心脏病（先心病）的１０％。ＰＳ可单独存在，也可合并其它血管畸形。外科手术治疗死亡率约为２％～３％，我院１９８７年１１月～１９９７年５月采用经皮球囊肺动脉瓣成形术（ＰＢＰＶ）治疗ＰＳ９４例，均取得满意的疗效，现报...     

成人房间隔缺损的临床特点及外科治疗

成人房间隔缺损的临床特点及外科治疗王乐纯国鸿锦姜克勤郭万红（淄博市中心医院心外科，淄博市２５５０３６）关键词房间隔缺损；外科治疗；先天性心脏病我院１９８７年６月～１９９５年１２月收治成人房间隔缺损（房缺）３５例，占同期房缺手术的６１％。本文就成人房缺...     

成人先天性心脏病房间隔缺损的外科治疗及围术期处理

探讨先天性心脏病房间隔缺损（ＡＳＤ）手术治疗及围术期处理的可行性，报告了５８例成人先天性心脏病房间隔缺损，全部在体外循环下进行了手术修补。术后早期有２７例发生左心衰竭，２例出现低心排出量综合征，３例成人呼吸窘迫综合征（ＡＲＤＳ）经气管切开，２例胸骨后感染；全组病人无死亡；随访１～９年，全组病人均恢复了工作与学习。提示加强围术期的综合处理是保证手术成功，降低死亡率的关键。     

成人先天性心脏病房间隔缺损的外科治疗及围术期处理

探讨先天性心脏病房间隔缺损（ＡＳＤ）手术治疗及围术期处理的可行性，报告了５８例成人先天性心脏病房间隔缺损，全问体外循环进行手术修补。术后早期有２７便发生左心衰竭，２例出现低心排邮量综合征，３例成人呼吸窘迫综合征（ＡＲＤＳ）经气管切开，２例胸骨后感染；全组病人无死亡；随访１－９年，全组病人均恢复了工作与学习。提示加强围术期的综合是保护手术成功，降低死亡率的关键。     

33例消化道出血患儿病因分析

目的：了解儿童消化道出血的病因。方法：采用回顾性调查方法对３３例消化道出血患儿进行病因分析。结果：３３例消化道出血患儿中，由十二指肠球部溃疡引起的消化道出血有２１例（６３６％），十二指肠球部溃疡伴浅表性胃炎２例（６０％），糜烂性胃炎１例（３０％），胃溃疡１例（３０％），空肠息肉１例（３０％），消化道多发性息肉综合症１例（３０％），血小板减少性紫瘢１例（３０％），过敏性紫瘢１例（３０％），肝硬化食道下段静脉曲张１例（３０％），青紫型先天性心脏病（单心室）１例（３０％），不明原因者２例（６０％）。结论：十二指肠球部溃疡及胃炎、胃溃疡是儿童时期消化道出血的最常见病因。     

视网膜母细胞瘤9例临床分析

视网膜母细胞瘤是婴幼儿中起源于原始视网膜干细胞的恶性肿瘤。本文对我院１９７２～１９８０年收治的９例视网膜母细胞瘤进行临床和病理分析。１　临床资料１１　一般资料　９例患者中,男８例,女１例。右眼６例（６６６７％）,左眼２例（２２２２％）,双眼１例（１１１１％）。就诊时年龄全部为４岁以内,年龄最小８个月,最大４岁。１２　临床分期　眼内期２例（２２２２％）,青光眼期４例（４４４４％）,眼外期２例（２２２２％）,转移期１例（１１１１％）。１３　治疗　９例均采取了手术治疗或手术治疗辅以…     

室间隔缺损的外科治疗

室间隔缺损的外科治疗唐燕华（第二附属医院胸外科南昌３３０００６）室间隔缺损（室缺）是最常见的先天性心脏病,一旦发现,宜在适当年龄进行手术治疗。１９９４年１月至１２月我们收治室缺患者３５例,除１例因手术后误吸致死外均存活,效果显著,现报告如下：１资料与...     

新生儿危重先天性心脏病8例报道

目的 对生后1周内的新生儿早期识别危重先天性心脏病(先心病).方法 回顾分析新生儿危重先心病8例,根据临床表现和心脏超声检查结果 ,分析其特点. 结果 青紫型先心病7例:大动脉转位4例,法洛四联症、肺动脉闭锁伴室间隔缺损(室缺)、左心发育不良综合征各1例;非青紫型先心病1例出生后漏诊至29天患肺炎时诊断主动脉缩窄伴室缺和房缺.生后1周内有心杂音者仅4例(1、2、4、6天), 7例及时做心脏超声检查而确诊.7例均放弃治疗死亡,1例法洛四联症18个月时手术,现4岁5个月发育良好. 结论 新生儿出生后遇中心性青紫虽无心杂音,应做心脏超声检查及时诊断危重先心病及转院,常规摸主动脉搏动避免漏诊主动脉缩窄.     

CONGENITAL CARDIOVASCULAR MALFORMATIONS IN CHINESE CHILDREN WITH DOWN''S SYNDROME .

149 Chinese children (70 boys, 79 girls) with Down's syndrome and congenital heart disease were studied. Diagnosis of the cardiac abnormality was made by cardiac catheterisation in 119, two-dimensional echocardiography in 23 and autopsy in 7. The commonest lesion was ventricular septal defect which was present in 43.6%, a higher frequency than that reported in Caucasians. Other common lesions included atrioventricular septal defect (15.4%), atrial septal defect (13.4%), tetralogy in Fallot (13.4%) and patent ductus arteriosus (12.1%). Multiple lesions occurred in 36% of the cases, with patent ductus arteriosus, the most frequent coexisting lesion. Other cyanotic congenital heart conditions were very rare and coarctation of aorta was not seen. An aberrant right subclavian artery arising from the descending aorta was present in 16.5% and abnormalities of the radial artery at the wrist were found in 19%. The literature on patterns of congenital heart diseases seen in Down's syndrome was reviewed.     

成人先天性心脏病的外科治疗

目的总结成人先天性心脏病的围手术期处理经验.方法对25例成人先天性心脏病的围手术期处理资料进行分析,其中房间隔缺损合并三尖瓣关闭不全（ASD＋TR）6例;室间隔缺损（VSD）9例,其中合并肺动脉高压（PH）5例,合并二尖瓣关闭不全（MR）1例,合并TR 2例;动脉导管未闭（PDA）7例（合并肺动脉高压2例）;法洛四联症（ToF）3例.结果死亡1例,24例治愈出院,随访1-38个月,心功能明显改善.结论手术时机的选择、满意的畸形矫治和合并肺动脉高压、房室瓣关闭不全的处理,积极的围术期心功能维护是成人先天性心脏病手术成功的关键.     

18例儿童二尖瓣畸形的外科治疗

目的:总结18例合并二尖瓣畸形的儿童先心病病历,探讨儿童二尖瓣畸形的外科手术方法。方法:自1997年9月至2002年4月期间,共为18例合并二尖瓣畸形的先心病儿童施行手术,年龄2～15岁,体重10～38kg。二尖瓣狭窄兼关闭不全(MS+MI)+动脉导管未闭(PDA)2例,MI+PDA2例,MI+室间隔缺损(VSD)5例,MI+PDA+VSD1例,MI+房间隔缺损(ASD)8例;其中16例行二尖瓣成形术,2例行二尖瓣置换术。结果:无手术及术后死亡,无残留术后并发症及再手术,均痊愈出院;术后随访2个月～4年,效果良好。结论:儿童二尖瓣畸形多为先天性,常合并其他先天性心脏病,应在矫治其他先心病同时治疗二尖瓣病变;根据病变不同,可选择瓣环环缩,瓣叶裂缝合,“双孔”二尖瓣成形及二尖瓣置换等手术方法。     

新生儿危重先天性心脏病的外科治疗

目的：总结连续8例新生儿危重先天性心脏病（先心病）的外科治疗结果和经验。方法：2001年5月至2002年2月,手术治疗8例危重先心病新生儿,手术年龄6-30d,体重3-4.5kg,包括室间隔完整的完全性大动脉错位3例,室间隔缺损合并房间隔缺损（ASD）2例,完全性房室隔缺损1例,心上型完全性肺静脉异位引流合并ASD1例,动脉导管未闭1例。对动脉导管未闭（PDA）患儿在常温全麻下结扎,其余7例均在中低温或深低温体外循环下行心脏大血管畸形解剖矫治。结果：8例均治愈,在监护室逗留2-10d,术后7-15d出院。术后并发症有低心排、纵隔感染及呼吸窘迫综合征。出院后随访结果满意。结论：对新生儿危重复杂先心病应早期诊断,积极开展手术治疗。     

Incidence of congenital heart disease in tertiary care hospital

Aims and Objectives: The present study was under taken to determine the spectrum, clinical profile and outcome of patients with congenital heart disease (CHD) admitted to a tertiary care hospital. Materials and methods: This is a retrospective, observational hospital based study conducted during January 2006 to December 2006. Out of 14461 admissions, 84 were cases of CHD. Only patients with echocardiographic proof of CHD were included in the study. Detailed clinical and laboratory findings and outcome of all cases were noted in pre-structured formats. Data were entered in MS-excel. Data was analyzed by software SPSS version 10. Results: The incidence of CHD was 5.8 per 1000 hospitalized patients. Out of 84 CHD cases, 51 were males and 33 females; with a male to female ratio of 1.5:1. CHD presented more frequently during infancy (46 %). Acyanotic heart disease was detected in 58 (69 %) cases while cyanotic heart disease was detected in 26 (31%) cases. Among acyanotic heart disease, ventricular septal defect (VSD) was found in 49 (58.3%), atrial septal defect (ASD) in 4 patients (4.8%), endocardial cushion defect (ECD) in 2 patients (2.4%) and dextrocardia was found in 3 patients (3.6%). Among cyanotic heart disease, Tetralogy of Fallot (TOF) accounted for 13.1%, total anomalous pulmonary venous connection (TAPVC) 3.6%, transposition of great arteries (TGA) with VSD 1.2% and unspecified cases of heart disease was found in 13.1%. VSD and TOF were the most common lesions while other CHD like ASD, dextrocardia, TAPVC, ECD, TGA with VSD were encountered less frequently. The most common clinical presentations were failure to thrive (FTT) and developmental delay (86.9%), breathlessness (69%), lower respiratory tract infection (LRTI) (52%), congestive cardiac failure (CCF) (46%), cyanosis (20.2%), cyanotic spell (9.5%) and infective endocarditis (9.5%). The mortality rate was 20 %. Conclusion: The incidence of CHD was 5.8 per thousand hospitalized children. VSD, TOF were the most common congenital cardiac lesion. VSD was observed either isolated or associated with other lesions like TGA. The mortality rate was 20 %. The mortality usually occurred in those patients complicated with congestive cardiac failure, lower respiratory tract infection and infective endocarditis. Key words: congenital heart disease, epidemiology, ventricular septal defect, Tetralogy of Fallot.     

经胸彩色超声心动图在先天性心脏病介入封堵术中的应用评价

目的:探讨经胸彩色超声心动图(TTE)在先天性心脏病封堵术前选择病例和术中及术后疗效观察中的应用价值。方法:术前应用TTE检查,选择适合行先天性心脏病封堵术患者37例,其中20例继发孔型房间隔缺损(ASD),10例膜周部型室间隔缺损(VSD),7例动脉导管未闭(PDA),患者均采用Amplatzer封堵器介入治疗,封堵器选择大于TTE测值的2~4 mm。术中在X线和TTE监测下观察封堵器的释放过程。术后1天、1周、1个月及6个月应用TTE观察封堵伞有无脱落,房、室间隔及大动脉水平有无分流,心脏大小变化。结果:20例ASD封堵成功19例,10例VSD封堵成功10例,7例PDA封堵成功7例。术后1天复查,1例ASD患者有少量残余分流,1例VSD患者三尖瓣瓣下见少量返流,2例VSD封堵术后出现不同程度的传导阻滞。随访1~6个月,均未发现有残余分流。结论:TTE在封堵术前选择合适病例,以及选择封堵器的大小,术中监测封堵器的位置是否准确,术后观察有无残余分流,疗效评价等方面有着重要的作用。     

先天性心脏病感染性心内膜炎的外科治疗

目的 总结１９９０年３月至１９９８年７月在我院手术治疗的４４例先天性心脏病并发心内膜炎患者的诊断和治疗经验。方法 男３０例,女１４例,平均年龄３１．２岁,血培养２８例,阳性１２例,３７例在感染控制后手术,７例于感染活动期手术。所有病例均彻底清除了感染灶,纠治瓣膜病变及先心病。     

Epidemiology of rheumatic and congenital heart diseases in school children.

A stratified random sample of 10,263 school-going children in the age group of 6-16 years from government and private schools were screened for the prevalence of rheumatic fever, rheumatic heart diseases and congenital heart diseases. Fourteen children were found to have rheumatic heart disease with valvular lesions either single or in combination eg, pure mitral stenosis (6 cases), mitral regurgitation (4 cases), combined mitral stenosis and mitral regurgitation (3 cases) and aortic and mitral regurgitation (one case). Eight children had congenital heart diseases in the form of ventricular septal defect (3 cases), atrial septal defect (2 cases), patent ductus arteriosus (2 cases) and congenital bicuspid aortic valve (one case) while none had active rheumatic fever.