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目的比较室间隔缺损部分较大的完全性房室间隔缺损行1.5片法与改良单片法治疗的手术效果。方法回顾性分析2005年1月至2016年1月我中心室间隔缺损部分较大的完全性房室间隔缺损患儿79例的临床资料。其中男37例、女42例,中位年龄8个月(1.5个月至10.2岁)。45例行改良单片法,男20例、女25例,中位年龄6个月(1.5个月至10.2岁);34例行1.5片法,男17例、女17例,中位年龄5.3个月(2.5个月至8.3岁)。所有入选患儿不合并右室双出口、单心室及大动脉异位等复杂畸形。结果在改良单片法手术组中死亡率及再手术率均高于1.5片法组,改良单片法组中2例术后早期死亡(4.4%),其中1例因术后瓣膜反流而心力衰竭,1例死于重症肺炎引起的呼吸衰竭;3例再手术者,其中2例因瓣膜反流行瓣膜成形术,1例因残余室间隔缺损而再次手术,1.5片法组无死亡及再次手术者。两组中均无左室流出道梗阻及房室传导阻滞发生。结论1.5片法治疗室间隔缺损部分较大的完全性房室间隔缺损患者效果较好。
Objective To compare the effect of 1.5-slice method and modified monolithic slice method in the treatment of larger complete atrioventricular septal defect with ventricular septal defect. Methods The clinical data of 79 patients with complete atrioventricular septal defect with large partial septal defect in our department from January 2005 to January 2016 were retrospectively analyzed. There were 37 males and 42 females, with a median age of 8 months (1.5 months to 10.2 years). 45 routine modified monolithic method, 20 males and 25 females, the median age of 6 months (1.5 months to 10.2 years); 34 patients with 1.5 films, 17 males and 17 females, the median age of 5.3 Months (2.5 months to 8.3 years). All selected children without right ventricular double outlet, single ventricle and aortic ectopic and other complex deformities. Results In the modified monolithic surgery group, the mortality and reoperation rate were higher than those of the 1.5-slice method group. Two of the modified monotherapy group’s early postoperative deaths (4.4%), of which 1 were due to postoperative valve regurgitation 1 died of respiratory failure caused by severe pneumonia; 3 cases of reoperation, including 2 cases of valvular retrograde valvuloplasty, 1 case of reoperation due to residual ventricular septal defect, 1.5 no death of the method group and again Surgeon. No left ventricular outflow tract obstruction and atrioventricular block occurred in both groups. Conclusion 1.5 slices of the treatment of ventricular septal defect larger partial complete atrioventricular septal defect patients better.