3个月以下小婴儿先天性心脏病的外科治疗

目的探讨3个月以下小婴儿先天性心脏病（CHD）的外科治疗方法。方法3个月以下小婴儿各种CHD78例，男52例，女26例，年龄最小生后10h，平均体重（3．50±2．92）kg，均在体外循环下行急诊或亚急诊手术。结果手术死亡7例，总死亡率为8．8％，其中完全性大动脉错位行Switch手术死亡2例（22．2％），室间隔缺损伴重度肺高压死亡3例（5．1％），完全性肺静脉异位引流和右室双出口各死亡1例。无残余分流和Ⅲ°房室传导阻滞等严重并发症发生。结论对小婴儿危重复杂CHD应早期干预，准确把握手术时机，及早手术，以免失去最佳手术时机和增加死亡率。

Surgical treatment of congenital heart disease for young infants

Objective To introduce the experience of surgical treatment in 78 young infants, aged less than 3 months,with congenital heart disease （CHD）. Methods From January 2005 to December 2006,there were 78 young infants aged less than 3 months old,undergoing all kinds of cardiac surgery. Among them,52 were males and 26 females. The age of smallest baby was 10 h after birth. Mean weight was （ 3.50 ± 2.92） kg. All of the infants were subjected to emergency operation or partial - emergency operation under extracorporeal circulation. Results Seven infants died in the operation room with total mortality being 9.58% ,including 2 infants with complete transposition of the great artery subject to Switch operation （22.2%） ,3 with ventricular septal defect with severe pulmonary hypertension （5.1%） , 1 with total anomalous pulmonary venous drainage and 1 with double - outlet right ventricle. There were no severe complications, such as residual shunt and Ⅲ° atrioventricular block. Conclusion For young infants with severe and complex CHD, it is indicated for early intervention, accurate operation opportunity, and early operation.