18例儿童二尖瓣畸形的外科治疗

Surgical treatment of eighteen cases of mitral abnormality of children

目的:总结18例合并二尖瓣畸形的儿童先心病病历,探讨儿童二尖瓣畸形的外科手术方法。方法:自1997年9月至2002年4月期间,共为18例合并二尖瓣畸形的先心病儿童施行手术,年龄2～15岁,体重10～38kg。二尖瓣狭窄兼关闭不全(MS+MI)+动脉导管未闭(PDA)2例,MI+PDA2例,MI+室间隔缺损(VSD)5例,MI+PDA+VSD1例,MI+房间隔缺损(ASD)8例;其中16例行二尖瓣成形术,2例行二尖瓣置换术。结果:无手术及术后死亡,无残留术后并发症及再手术,均痊愈出院;术后随访2个月～4年,效果良好。结论:儿童二尖瓣畸形多为先天性,常合并其他先天性心脏病,应在矫治其他先心病同时治疗二尖瓣病变;根据病变不同,可选择瓣环环缩,瓣叶裂缝合,“双孔”二尖瓣成形及二尖瓣置换等手术方法。

Objective We summarized eighteen cases of congenital heart disease of children combined with mitral abnormality,and discuss surgical method of mitral abnormality of children.Method From September nineteen ninty seven to April two thousand and two,we carry out operation on eighteen cases of congenital heart disease of children combined with mitral abnormality,age varies from two to fifteen years old,weight varies from ten to thirty eight kilogram.In these cases,there are two cases of patent ductus ar-teritis combined with mitral stenosis and mitral insufficiency,two cases of patent ductus arteritis combined with mitral insufficiency,five cases of ventricular septal defect combined with mitral insufficiency,one case of ventricular septal defect combined with patent ductus arteritis and mitral insufficiency,eight cases of atrial septal defect combined with mitral insufficiency.sixteen cases of them carry out mitral valve rebuilding operation,and two cases of them carry out mitral valve replacing operation.Results There are no death in the operation and post operation,no complication of post operation and reoperation,and these patients are all go home healthily.Tracing of post operation varies from two months to four years,there are good results.Conclusion Mitral abnormalities of children are often congenital,and combined with other congenital heart diseases,we should treat mitral pathology at the time we correct other congenital heart diseases;according to different pathology,we can choose circling contraction of valvular circle,closure of fissure of valve lobe,'double hole'valve rebuilding operation and mitral valve replacing operation and so on.