67例继发孔房间隔缺损的外科治疗和围术期处理

目的总结继发孔房间隔的外科治疗和同术期的处理。方法共手术治疗继发孔房间隔缺损患者67例，其中男24例，女43例，年龄1．5～64岁；中度以上肺动脉高爪32例。所有病例均在全麻体外循环下采用直接缝合、心包或涤纶片修补房间隔缺损；合并畸形均同期手术矫治。结果全组无死亡，术后随访1～15个月，心功能均有明显改善。结论严格把握手术适应证、选择手术方式、确诊后应尽早手术，对有肺动脉高压增加手术危险者加强术后护理是提高手术疗效的关键。

Surgical treatment and perioperative management of 67 cases secundum atrial septal defects

Objective To summarize the surgical treatment and perioperative management of secundum atrial septal defects （ASD）. Methods Among 67 cases, 24 males, 43 females, aged from 1.5 to 64 years, secundum ASD in 32 cases associated with moderate pulmonary hypertension. All surgical operations were finished by sutured directly, pericardium or repaired with patches under general anesthesia and hypothermia. Meanwhile, the work of repairing the intracardiac malformation was done during the operations. Results There was no death in the whole groups. The heart functions of cases were improved obviously in followed - up 1 - 15 months. Conclusion Strict control of indications and skillful surgical technique are essential for improving the curative effect. Also, operation should be performed on patients with ASD as soon as possible when the operation indication is confirmative. Strengthening postoperative care is another important point to patients with pulmonary arterial hypertension.