婴幼儿室间隔缺损合并肺动脉高压的外科治疗效果

目的分析60例婴儿室间隔缺损合并肺动脉高压手术结果,探讨影响婴幼儿室间隔缺损合并肺动脉高压外科治疗疗效的因素。方法 2009年2月-2010年3月湖南省儿童医院对60例室间隔缺损合并肺动脉高压患儿采用在中度低温、中低流量体外循环下行VSD修补术,VSD采取补片修补55例,直接缝合5例;ASD和PDA予以直接缝闭,行手术治疗。结果全组患儿治愈59例,1例患儿死于低心排出量综合征,死亡率为1.7%。随访6个月~2年,无其他并发症和死亡病例。结论婴儿室间隔缺损合并肺动脉高压经内科治疗无效时应及时手术治疗,术前积极予以支持疗法,术中精细操作可有效地降低手术患儿死亡率和术后并发症。

Surgical Treatment Efficacy of Infants with Ventricular Septal Defect Complicated by Pulmonary Artery Hypertension

Objective To analyze the surgical outcomes of 60 infants with ventricular septal defect(VSD) complicated by pulmonary artery hypertension(PH),and to explore the impact of factors on curative effect of infant surgical treatment. Methods Sixty infants with VSD and PH were operated with extracorporeal circulation in hypothermia from February 2009 to March 2010 in the Children’s Hospital of Hunan Province.Patch repairs were performed in 55 cases of VSD,and direct suture was performed in 5 cases of VSD.The cases of ASD and PDA were received direct suture. Results Fifty-nine infants with VSD and PH were cured,and 1 infant died from low cardiac output syndrome.The hospital mortality was 1.7%.Follow-up was completed in all 59 survived infants for 6 months to 2 years,and all developed well. Conclusions Infants with VSD complicated by PH should be operated on as early as possible.Active support treatment should be taken before the operation,and careful operation should be taken in surgical procedures.These measures can effectively reduce mortality and postoperative complications of the surgery in children.