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目的:探讨儿童先天性心脏病室间隔缺损并二尖瓣关闭的外科治疗方法及临床效果。方法:回顾性分析2009年6月~2012年5月经室间隔修补及二尖瓣成形术治疗的36例儿童室间隔缺损并二尖瓣关闭患者临床资料。结果:全组无手术死亡病例,术后左房平均压18±3.9 cmH_2O,患者血液动力学稳定,心功能恢复良好,9例合并肺动脉高压患者PP/PS降至0.26~0.35,围术期无明显并发症出现。术后3~6个月复查,患者活动耐力明显增强,彩色多普勒超声室间隔缺损无残余分流,31例无二尖瓣反流,5例轻微反流,无需治疗。结论:室间隔缺损修补、二尖瓣成形术治疗儿童室间隔缺损并二尖瓣关闭可获良好效果,对合并肺动脉高压者严格手术适应证选择,尽可能避免2次手术治疗。
Objective: To investigate the surgical treatment of children with congenital heart disease ventricular septal defect and mitral valve closure and clinical effects. Methods: The clinical data of 36 children with ventricular septal defect and mitral valve closure who underwent transseptal and mitral valvuloplasty from June 2009 to May 2012 were retrospectively analyzed. Results: All the patients died without surgery. The average left atrium pressure was 18 ± 3.9 cmH 2 O after operation. The hemodynamic stability and cardiac function recovered well. The PP / PS in 9 patients with pulmonary hypertension decreased to 0.26 ~ 0.35. Obvious complications appear. Postoperative 3 to 6 months review, patient activity endurance was significantly enhanced, color Doppler ultrasound ventricular septal defect without residual shunt, 31 cases without mitral regurgitation, 5 cases of minor reflux, without treatment. CONCLUSIONS: Ventricular septal defect repair and mitral valvuloplasty are effective in treating ventricular septal defect and mitral valve closure in children. Selection of indications for severe surgery combined with pulmonary hypertension avoids 2 surgeries as far as possible.