成人先天性心脏病340例外科治疗的临床分析

目的：探讨成人先天性心脏病的临床特点及手术适应征。方法：回顾１９８０年１月～１９９８年４月在我院接受外科治疗的３４０例成人先天性心脏病病例，并选同时期外科治疗的先天性心脏病１２３５例作为对照组，进行统计分析。结果：本组成人先心以房缺（３７９％）和室缺（３３２％）最多见，青紫型先心病较少，以法四为主（４１％）。手术早期死亡率１８％，对照组手术早期死亡率２６％，无明显差异。结论：成人先心病年龄不是选择手术的关键；非青紫型先心病肺动脉高压的产生和加重与否是选择手术的关键；青紫型先心病其病理继发性改变和并发症是手术成功的关键，在掌握成人先心病围术期特点的情况下仍应积极考虑手术治疗，并可取得较好疗效

Surgical Treatment of 340 Adult Patients With Congenital Heart Diseases: Clinical Analysis

Obiecfive:Discussing the clinical characteristics and the surgical indications of adult congenital heart diseases Methods: Retrospecting 340 adult patients with congenital heat diseases who underwent surgical treatment in hospital from 1980 1 to 1998 4,and comparing with 1235 surgically treated children with congenital heart diseases of the same period Results:In adult, atrial septal defect (37 9%) and ventricular septal defect were higher, cyanotic congenital heart diseases were fewer, mainly terralogy of Fallot (4 1%) ,moratlity after operation was 1 8%, compared with that in children (2 6%) Conclusions: Age is not the key for selecting surgical operation in adult congenital heart diseases, the generation and progression of pulmonary hypertension are crucial in cyanotic congenital heart diseaes, secondary pathologic changes and complications are the key of surgical success in cyanotic congenital heart disease Under keeping in mind the characteristics of perioperation in adult congenital heart diseases, operation should be actively considered and good result may be resulted