CAJ | 학술논문

目的总结婴幼儿完全性房室隔缺损外科治疗的临床经验.方法本院2004年6月至2013年12月共手术治疗婴幼儿完全性房室间隔缺损56例,年龄53 d至12个月.全部患者术前经心脏超声检查确诊,其中18例患儿同时行心脏血管CTA检查.Rastelli A型44例,B型3例,C型9例.手术采用单片法修补37例,双片法修补3例,改良单片法修补16例.术后机械通气时间26 ～ 172 h,住ICU时间3～19d.结果术后早期院内死亡5例,死亡原因分别为严重低心排2例,肾功能衰竭2例,严重肺部感染1例;晚期死亡1例,术后2个月因二尖瓣中、重度返流,死于心肺功能衰竭.手术死亡率10.7％ (6/56).47例患儿术后随访3个月至5年,心功能恢复良好.结论完全性房室间隔缺损一旦诊断明确应在生后6个月至1周岁及时手术,早期手术临床效果满意.手术效果关键取决于对心内结构的仔细探查以及彻底纠正心内畸形.
목적 총결영유인완전성방실격결손외과치료적림상경험.방법 본원2004년6월지2013년12월공수술치료영유인완전성방실간격결손56례,년령53 d지12개월.전부환자술전경심장초성검사학진,기중18례환인동시행심장혈관CTA검사.Rastelli A형44례,B형3례,C형9례.수술채용단편법수보37례,쌍편법수보3례,개량단편법수보16례.술후궤계통기시간26 ～ 172 h,주ICU시간3～19d.결과 술후조기원내사망5례,사망원인분별위엄중저심배2례,신공능쇠갈2례,엄중폐부감염1례;만기사망1례,술후2개월인이첨판중、중도반류,사우심폐공능쇠갈.수술사망솔10.7％ (6/56).47례환인술후수방3개월지5년,심공능회복량호.결론 완전성방실간격결손일단진단명학응재생후6개월지1주세급시수술,조기수술림상효과만의.수술효과관건취결우대심내결구적자세탐사이급철저규정심내기형.
Objective To summarize the clinical experience of surgical treatment for complete atrioventricular septal defect in infants.Methods From December 2013 to June 2004,56 patients aged from 53 days to 12 months with complete atrioventricular septal defect were undergone operations.All patients were diagnosed by 2D-echocardiography,and 18 patients underwent cardiovascular computed angiography (CTA).Rastelli type A had 44 cases,type B 3 cases,and type C 9 cases.The single pericardium patch repair was used for 37 cases,the two-patch repair for 3 cases,and the modified single-patch repair for 16 cases.The time of mechanical ventilation was 26 to 172 hours,and the time of staying at Intensive Care Unit (ICU) was 3 to 19 days.Results There were 5 early deaths caused by severe low cardiac output in 2 cases,renal failure in 2 cases,and severe pulmonary inflammation in 1 case.One late death was due to severe mitral regurgitation with pneumonia and heart failure.The operative mortality was 10.7％.A total of 47 patients was followed-up for 3 months to 5 years after surgery and their heart function was satisfactory.Conclusions The operation should be done between 6 months and 1 year when the diagnosis of complete atrioventricular septal defect (CAVSD) is clear.Its early surgical intervention is satisfactory.The result of surgical treatment for CAVSD depends on both probing intracardiac anatomy carefully and complete correction of associated cardiac abnormalities.