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目的分析60例婴儿室间隔缺损合并肺动脉高压手术结果,探讨影响婴幼儿室间隔缺损合并肺动脉高压外科治疗疗效的因素。方法 2009年2月-2010年3月湖南省儿童医院对60例室间隔缺损合并肺动脉高压患儿采用在中度低温、中低流量体外循环下行VSD修补术,VSD采取补片修补55例,直接缝合5例;ASD和PDA予以直接缝闭,行手术治疗。结果全组患儿治愈59例,1例患儿死于低心排出量综合征,死亡率为1.7%。随访6个月~2年,无其他并发症和死亡病例。结论婴儿室间隔缺损合并肺动脉高压经内科治疗无效时应及时手术治疗,术前积极予以支持疗法,术中精细操作可有效地降低手术患儿死亡率和术后并发症。
Objective To analyze the results of 60 cases of ventricular septal defect complicated with pulmonary hypertension in infants and young children and explore the factors influencing the curative effect of infantile ventricular septal defect and pulmonary hypertension. Methods From February 2009 to March 2010, 60 cases of children with ventricular septal defect complicated with pulmonary hypertension underwent moderate VSD repair with moderate hypothermia, moderate to low flow cardiopulmonary bypass in Hunan Children’s Hospital from February 2009 to March 2010. The VSD was treated with patch repair in 55 cases. Suture in 5 cases; ASD and PDA to be directly sutured, surgical treatment. Results The whole group of children were cured in 59 cases, 1 patient died of low cardiac output syndrome, the mortality rate was 1.7%. Follow-up 6 months to 2 years, no other complications and deaths. Conclusion Infantile ventricular septal defect with pulmonary hypertension should be promptly surgically treated with ineffective medical treatment, and preoperative positive supportive therapy. Fine operation can effectively reduce the mortality and postoperative complications in children undergoing surgery.