摘要
目的：分析婴儿常见先天性心脏病的手术疗效。方法回顾性分析1004例婴儿常见先天性心脏病手术的临床资料，男508例，女496例，年龄0.7～12.0（7.4±3.6）个月，体质量2.4～11.5（6.8±2.2）kg。室间隔缺损（VSD）680例，房间隔缺损（ASD）92例，动脉导管未闭（PDA）70例，肺动脉瓣狭窄（PS）12例，VSD＋ASD 83例，VSD＋PDA 27例，VSD＋中至重度二尖瓣关闭不全（MI）12例，VSD＋ASD＋MI 3例，VSD＋PS 5例，VSD＋ASD＋PS 2例，VSD＋双腔右心室（DCRV）3例，ASD＋PS 7例，ASD＋PDA 8例。结果患儿体外循环时间21～72（40.2±28.6） min，主动脉阻断时间4～37（20.7±15.5）min。住院病死率为0.8%（8/1004）。术后发生低心排出量综合征18例，细菌性心内膜炎2例，肺部感染27例，肺不张6例，气胸2例，喉头水肿11例，切口液化12例，胸骨哆开3例，第三度房室传导阻滞1例。术后6～12个月门诊随访845例[84.2%（845/1004）]，超声心动图发现VSD残余分流9例，轻度MI 5例，中度MI 1例。结论基层医院开展婴儿常见先天性心脏病手术，只要把握好手术时机，术中注意心肌及其他重要脏器功能保护，术后给予严密监护和精细处理，可取得满意的临床效果。
Objective To analyze the surgery effect of infant common congenital heart diseases. Methods The clinical data of 1 004 infants with common congenital heart disease were retrospectively analyzed, with male in 508 cases, female in 496 cases, age from 0.7 to 12.0 （7.4 ± 3.6） months, and body weight from 2.4 to 11.5 （6.8 ± 2.2） kg. Among them , there were the ventricular septal defect （VSD） in 680 cases, atrioventricular septal defect （ASD） in 92 cases, patent ductus arteriosus （PDA） in 70 cases, pulmonary valve stenosis （PS） in 12 cases, VSD ＋ASD in 83 cases, VSD ＋ PDA in 27 cases, VSD＋moderate to severe mitral insufficiency （MI） in 12 cases, VSD＋ASD＋MI in 3 cases, VSD＋PS in 5 cases, VSD＋ASD＋PS in 2 cases, VSD＋double chamber right ventricle （DCRV） in 3 cases, and ASD＋PS in 7 cases, ASD＋PDA in 8 cases. Results The extracorporeal circulation time was 21-72 （40.2 ± 28.6） min, and aortic occlusion time was 4-37 （20.7 ± 15.5） min. The in hospital mortality was 0.8%（8/1 004）. Postoperative complications included low cardiac output syndrome in 18 cases, bacterial endocarditis in 2 cases, pneumonia in 27 cases, pulmonary atelectasis in 6 cases, pneumothorax in 2 cases, laryngeal edema in 11 cases, incision fat liquefaction in 12 cases, sternal dehiscence in 3 cases, and third-degree atrioventricular block in 1 case. Eight hundred and forty-five infants （84.2%, 845/1 004） were followed up for 6-12 months.The echocardiogram found 9 cases with residual VSD shunt, 5 cases with mild MI and 1 case with moderate. Conclusions In primary hospital, Seizing the opportunity of surgery, attention on protection of myocardium and other important of organ function during operation, and postoperative intensive care and fine processing can achieve satisfactory clinical results in infant＆nbsp;common congenital heart diseases surgery.
出处
《中国医师进修杂志》
2016年第9期826-829,共4页
Chinese Journal of Postgraduates of Medicine
关键词
婴儿
心脏缺损
先天性
心脏外科手术
回顾性研究
Infant
Heart defects,congenital
Cardiac surgical procedures
Retrospective studies
