CAJ | 학술논문

目的探讨3月龄以下婴儿室间隔缺损合并肺炎急诊手术外科治疗适应证，手术技术及围手术期处理。方法回顾性分析2014年1月～2014年6月，3月龄以下合并肺炎室间隔缺损行急诊手术32例，均采用右腋下切口。其中28例带呼吸机，合并动脉导管未闭11例，合并卵圆孔未闭23例，均合并肺动脉高压，均在全麻低温体外循环下行室缺修补术及同期合并畸形矫治术。结果全组术后早期死亡1例，死亡率3.1%，术后心率失常4例，肺高压危象2例，低心排3例，气胸8例，给予对症处理后痊愈出院，残余分流5例。分流口均小于2<br>　　mm，随访1月，3月超声心动图已自动痊愈，生长发育良好。结论3月龄以下婴儿室间隔缺损合并肺炎行急诊手术采用右腋下切口效果良好，而准确把握手术的适应证，提高手术技术操作和加强围手术期处理是成功的关键。
목적탐토3월령이하영인실간격결손합병폐염급진수술외과치료괄응증，수술기술급위수술기처리。방법회고성분석2014년1월～2014년6월，3월령이하합병폐염실간격결손행급진수술32례，균채용우액하절구。기중28례대호흡궤，합병동맥도관미폐11례，합병란원공미폐23례，균합병폐동맥고압，균재전마저온체외순배하행실결수보술급동기합병기형교치술。결과전조술후조기사망1례，사망솔3.1%，술후심솔실상4례，폐고압위상2례，저심배3례，기흉8례，급여대증처리후전유출원，잔여분류5례。분류구균소우2<br>　　mm，수방1월，3월초성심동도이자동전유，생장발육량호。결론3월령이하영인실간격결손합병폐염행급진수술채용우액하절구효과량호，이준학파악수술적괄응증，제고수술기술조작화가강위수술기처리시성공적관건。
Objective To investigate the emergency operation in ventricular septal defect combined pneumonia babies under 3 months surgical indications, surgical technique and perioperative treatment. Methods A retrospective analysis in January 2014 to June 2014, during the period of 3 months following merger pneumonia 32 cases of ventricular septal defect underwent emergency surgery, adopt right subaxillary incision. 28 cases with breathing machine, merge artery catheter was not shut in 11 cases, 23 cases of combination of patent foramen ovale, merge pulmonary hypertension, in low temperature under extracorporeal circulation of general anesthesia room repair deficiency and at the same time combined surgery deformity correction. Results The whole set of early postoperative death in 1 case, 3.1% mortality rate, postoperative arrhythmia in 4 cases, 2 cases of pulmonary hypertension crisis and low cardiac 3 cases, 8 cases of pneumothorax, to suit the recovered after treatment, the residual shunt in 5 cases. FenLiuKou are less than 2 mm, followed up for 1 month, 3 months echocardiography has automatic recovery, growth and development is good. Conclusion Ventricular septal defect combined babies under 3 months pneumonia underwent emergency surgery using right subaxillary incision effect is good, and accurately grasp the indications for surgery, improve the technical operation and strengthen the perioperative treatment is the key to success.