论文部分内容阅读
目的:探讨小儿室间隔缺损合并重度肺动脉高压的外科治疗。方法:全组82例,年龄6～12(8.4±2.5)岁。临床均有明显症状。其中4例为干下型,余78例为膜周型。经右室切口修补2例;肺动脉切口修补2例;右房切口修补78例。结果:全组术后死亡3例,其原因均为呼吸功能衰竭。余79例术后恢复良好,随访疗效满意。结论:小儿室间隔缺损并重度肺动脉高压的手术疗效与下列因素有关:术前准确分析体、肺循环血流动力学指标;血管紧张素转化酶抑制剂的应用;注意心肌保护及手术操作技术;有效的围手术期处理。
Objective: To investigate the surgical treatment of ventricular septal defect with severe pulmonary hypertension. Methods: The whole group of 82 patients, aged 6 to 12 (8.4 ± 2.5) years old. Clinical symptoms are obvious. Among them, 4 cases were dry type and 78 cases were membrane type. 2 cases were repaired by right ventricular incision, 2 cases were repaired by pulmonary artery incision and 78 cases were repaired by right atrium incision. Results: All the patients died in 3 cases, all of which were caused by respiratory failure. The remaining 79 cases recovered well and the follow-up was satisfactory. CONCLUSIONS: The surgical efficacy of ventricular septal defect with severe pulmonary hypertension is associated with the following factors: accurate preoperative analysis of body volume, hemodynamic indices of pulmonary circulation; the use of angiotensin converting enzyme inhibitors; attention to myocardial protection and surgical techniques; effective Perioperative management.