婴儿心室间隔缺损255例治疗体会

目的探讨婴儿心室间隔缺损(VSD)外科治疗适应证、手术技术及围术期管理要点。方法作者回顾总结昆明市延安医院1997年1月至2007年9月255例婴儿VSD手术治疗的临床资料及随访情况。本组患儿年龄28d至12个月(平均9.7个月),体质量4～10kg(平均7.24kg),均在全身麻醉浅低温体外循环下手术,其中膜周部VSD219例、干下型VSD19例、肌部VSD6例、混合型11例。全组补片修复242例,直接缝合13例。结果全组围术期死亡13例,重要并发症13例,术后平均住院时间11d,出院时心功能和健康情况良好。结论婴儿VSD手术治疗效果良好;VSD如对心肺功能已造成损害或预计缺损难以自行闭合者均应在婴儿期手术修复;术中心肌保护及术后围术期管理至关重要。

Surgical Treatment for Ventricular Septal Defect in Infants

Objective We explored the effect of surgical treatment on ventricular septal defect （VSD） in infants, including the operative indications, surgical techniques and perioperative therapy. Methods All clinical of 255 consecutive infants from Jan. 1997 to Sem. 2007 were collected and studied retrospectively. The age of these infants range from 28 days to 12months （mean9.7）with the weight of 4 to 10 （meanT. 24）kg. The operations were performsed by cardiopuimonary bypass. VSD was perimembranous in 219, subpulmonary in 19, muscular in 6 and perimembranous-subarterial in 11. Patch repair was used in 242 and interrupted sutures in 13. Rusults 11 infants were dead after operation,14 with major operation compli-cations. The survivers were discharged with satisfactory recovery. Conclusion The operation for VSD in infants is safe and effective. Surgical repair is beneficial to infants with VSD, which has damaged the heart and lungs or its spontaneous cure in impossible. Myocardial preservation in the operation and the perioperative therapy is very important.