中华小儿外科杂志
中華小兒外科雜誌
중화소인외과잡지
CHINESE JOURNAL OF PEDIATRIC SURGERY
1997年
3期
130-132
,共3页
贾兵%张善通%陈张根%曹金红%王人荣%汤顺荣
賈兵%張善通%陳張根%曹金紅%王人榮%湯順榮
가병%장선통%진장근%조금홍%왕인영%탕순영
心间隔缺损%室%肺动脉楔压%主动脉瓣关闭不全
心間隔缺損%室%肺動脈楔壓%主動脈瓣關閉不全
심간격결손%실%폐동맥설압%주동맥판관폐불전
Ventricular septal defect%Pulmonary wedge pressure%Aortic valve insufficiency
目的:探讨先天性心脏病室间隔缺损(VSD)合并中重度肺动脉高压的外科治疗及围术期处理.方法:全组108例,年龄4~96(24.5±16.8)个月,体重4.7~20(11.4±6.8)kg.均有明显临床症状.其中32例为双动脉干下型VSD,其中4例伴有主动脉瓣脱垂和中度以上主动脉瓣返流.32例双动脉瓣下型VSD经肺动脉横切口,其他经右心房切口54例,右心室切口18例,另4例经右房右室双切口完成修补.结果:全组无死亡,2例发生右侧气胸,5例有左侧肺不张,无其他严重并发症.均顺利撤离呼吸机,拔除气管插管.结论:室间隔缺损合并中重度肺动脉高压的外科治疗,其成功的关键在于手术适应证掌握正确,术前准备充分,手术技术进步以及术后处理适当.
目的:探討先天性心髒病室間隔缺損(VSD)閤併中重度肺動脈高壓的外科治療及圍術期處理.方法:全組108例,年齡4~96(24.5±16.8)箇月,體重4.7~20(11.4±6.8)kg.均有明顯臨床癥狀.其中32例為雙動脈榦下型VSD,其中4例伴有主動脈瓣脫垂和中度以上主動脈瓣返流.32例雙動脈瓣下型VSD經肺動脈橫切口,其他經右心房切口54例,右心室切口18例,另4例經右房右室雙切口完成脩補.結果:全組無死亡,2例髮生右側氣胸,5例有左側肺不張,無其他嚴重併髮癥.均順利撤離呼吸機,拔除氣管插管.結論:室間隔缺損閤併中重度肺動脈高壓的外科治療,其成功的關鍵在于手術適應證掌握正確,術前準備充分,手術技術進步以及術後處理適噹.
목적:탐토선천성심장병실간격결손(VSD)합병중중도폐동맥고압적외과치료급위술기처리.방법:전조108례,년령4~96(24.5±16.8)개월,체중4.7~20(11.4±6.8)kg.균유명현림상증상.기중32례위쌍동맥간하형VSD,기중4례반유주동맥판탈수화중도이상주동맥판반류.32례쌍동맥판하형VSD경폐동맥횡절구,기타경우심방절구54례,우심실절구18례,령4례경우방우실쌍절구완성수보.결과:전조무사망,2례발생우측기흉,5례유좌측폐불장,무기타엄중병발증.균순리철리호흡궤,발제기관삽관.결론:실간격결손합병중중도폐동맥고압적외과치료,기성공적관건재우수술괄응증장악정학,술전준비충분,수술기술진보이급술후처리괄당.
Objective:To explore the surgical treatment of ventricular septal defects(VSD) with moderate or severe pulmonary hypertension. Methods:The open heart operation for closure of VSD was performed on 108 infants.Their ages were 24.5±16.8 months and weight was 11.4±6.8 kg.The types of VSD were subarterial in 32 infants and perimembranous in 76.According to informations from echocardiography,47 cases were associated with moderate pulmonary hypertension and the other 61 with severe pulmonary hypertension.Incisions were made on pulmonary artery(32),right atrium(54),right ventricle(18)and on both right atrium and right ventricle (4).Results:No perioperative death occurred.All patients were weaned from mechanical ventilation in 4~36 hours.Main complications were right pneumothorax in 2 infants and left pulmonary atelectasis in 5.Conclusions:Proper perioperative management is very important to the surgical treatment for VSD with moderate or severe pulmonary hypertension in infancy.