2085例小儿先天性室间隔缺损手术纠治的临床分析

分析影响小儿先心病室缺纠治术的因素，以提高手术成功率。回顾性分析２０８５例小儿先心室缺纠治术，手术死亡４８例，病死率２．３％。手术死亡与患儿的年龄、体重有关。年龄小于６个月，体重低于６ｋｇ者手术病死率为３５．７％和３０．０％，而年龄大于３岁，体重超过１６ｋｇ者手术病死率低于１．０％。先心室缺的手术时间取决于室缺的位置、大小和心内分流量。室缺伴肺动脉高压患儿必须在２岁前手术，对肺动脉瓣下型室缺患儿应早期手术，防止主动脉瓣脱垂导致主动脉瓣关闭不全．术中避免右室切口，保护术后右心室功能和术后肺动脉高压的处理是手术成功的关键。

Clinical Review of Surgical Repair of VSD on 2085 Pediatric Patients

Factors influencing the outcome of surgical repair on 2 085 cases with ventricular septal defects(VSD) were analysed.There were 48 deaths with a hospital mortality of 2.3%.The mortality in patients,younger than 6 months was 35.7%,and in those body weight lower than 6 kg was 30%,In those older than 3 years of age and body weight higher than 16 kg,the mortality was below 1%.The authors demonstrate that the timing of operation depends on the location,size and intracardiac shunting of the defects. If the patient is complicated by pulmonary hypertension, the operation must be performed on under 2 years of age. Subpulmonary VSD should be repaired early to prevent aortic insufficiency following valve prolapse. The key to successful surgery is avoidance of right ventricular incision, protection of right ventricular function and proper postoperative management of pulmonary hypertension.