先天性巨大房缺的外科治疗

Surgical Treatment of Congenital Large Atrial Septal Defect

目的:探讨巨大房缺手术治疗特殊性,提高巨大房缺的手术安全性和治疗效果。方法:通过对23例巨大房缺的手术治疗(其中常规体外循环下纠治17例、不停跳下纠治6例,补片修补17例、直接修补6例),对其术前诊断、病情和并发畸形的估计、手术方法和经验教训等进行总结分析。结果:22例手术顺利,治愈出院.仅1例围术期死亡;但发现术前心脏彩超对房缺的大小、分型、合并畸形的诊断等有一定的局限性,易于误诊、漏诊。结论:巨大房间隔缺损外科治疗疗效确实,安全性高,但应提高对其常常合并肺静脉异位引流的认识,以免造成手术困难、甚至发生危险。

objective:to study the particularity of operation of large atrial septal defect,increase the safety and treatment effect.Method:operations have been performed in 23 cases of large atrial septal defect(17 cases were done under routine cardiopulmonary bypass,6 cases were done with heart beating;17 cases were mended by the patch replacement,6 cases were mended directly),and preoperative diagnosis,condition of patients,the guess of complicated abnormality,operation method,experiences have been analyzed.Result:2...