婴幼儿室间隔缺损合并肺动脉高压的外科治疗
- 摘要:
- 目的 总结婴幼儿大型室间隔缺损(Ventricular Septal Defects ,VSD)合并肺动脉高压的外科治疗经验。方法 2008年10月至2009年5月共收治婴幼儿大型VSD 98例，男56例，女42例，年龄4 ~ 24个月，体重5.1 ~ 15.3 kg；均为单发，其中合并房间隔缺损(Atrial Septal Defect,ASD) 26例，合并三尖瓣关闭不全(Tricuspid Insufficiency, TI)18例，动脉导管未闭(Patent Ductus Arteriosus, PDA)12例。患儿均在全麻低温体外循环下实施一期矫治术。 结果 治愈95例，死亡3例，术后并发症16例，其中低心排出量综合征6例，肺不张4例，肺炎3例，心律紊乱2例，气胸1例，术后早期复查彩超，除5例有少量残余分流外，其余患儿心功能及瓣膜关闭均正常，患儿均痊愈出院。 结论 低体重、低年龄的大型室间隔缺损应尽早手术根治；术中尽量减轻体外循环损伤，保护脏器功能；术后加强呼吸道管理、预防低心排出量综合征和肺动脉高压危象是降低死亡率的关键。
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备注/Memo
作者单位：郑州市儿童医院心胸外科（河南省，450053）