24例室间隔缺损的外科治疗.docVIP

24 例先天性室间隔隔缺损手术治疗分析 冯世军 郭伟 （河南省驻马店市中心医院胸心胸外科， 驻马店 463000） 　　摘要:目的　总结先天性心脏病室间隔缺损的外科手术治疗及术后处理的经验。方法　　2004 年12 月～2010 年12 月我院手术治疗VSD 24 例,男15 例,女9 例,年龄3～24岁,平均12岁。均在低温体外循环下手术,必要时应用深低温低流量及改良超滤技术。直视缝合3例,补片修补21例。结果　本组术后无死亡。术后并发症6例，发生率25%，其中其中低心排1例，心律紊乱2例，肺不张1例，肺炎2例，术后早期复查彩超，除1例有少量残余分流外，心功能及瓣膜关闭均正常，所有患儿均痊愈出。结论　室间隔缺损;一旦确诊,应尽早手术,术中减轻体外循环损伤、注重脏器功能保护，术后加强呼吸道的管理、预防低心排和肺动脉高压危象的发生是降低并发症减少死亡率的关键。 关键词: 先天性心脏病;室间隔缺损, 手术治疗 The surgical treatment of congenital ventricular septal defect in 24 patients Guo wei Fengshijun (Department of Cardiothoracic Surgery, Zhumadian Munipical Central Hospital of Henan province, Zhumadian , 463000, China) [Abstract] Objective: To review the clinical experience of the surgical treatment of congenital ventricular septal defect(VSD) Methods: From Dec. 2004to Dec. 2010 ,24 cases were operated on for their VSD.Their ages ranged from 3 to 24 years (8 ±4 year) . All patients underwent VSD repair under hypothermic anaesthesia with cardiopulmonary bypass. If necessary , deep hypothermic and low flow , improved superfilter was used. 3 cases were repaired with direct stitch closure and 21 with patch closure.Subpulmonary VSD should be repaired early to preventaortic insufficiency. .Results: There was no death after operation.Therew ere 6 cases of postoperative complications,with the incidence rate as 25%.And the complications included low cardiac output syndrome(1cases), arrhythmia(2 cases), and atelectasis(1cases) pneumonia(2cases),In the early phase after operation,all cases were checked by color ultrasound and found that heart function and valve closure were all nomal except1cases with slight residue difflunce,All patients were discharged after full recovery.Conclusions: Ventricular septal defect should be operated on as early as possible, During the operation,extracorporeal circulation lesion should be all eviated,viscera functions portected,and aftero peration,the controlo fr espiratory ducts trengthened,and low cardiac output and high