先天性心脏病合并肺动脉高压外科治疗2169例室间隔缺损的外科治疗

Surgicaltreatmentofventricularseptaldefectin2169patients

作者单位自１９６４年６月至１９９３年６月手术治疗室间隔缺损（室缺）２１６９例。其中围膜部室缺１５２０例、肺动脉下室缺３８０例、隔瓣后室缺２４９例、肌部室缺５例、左室右房通道７例、多发型室缺８例。手术死亡率为０．７４％。合并严重肺动脉高压２７１例中，５１例中进行肺组织活检，并按Ｈｅａｔｈ－Ｅｄｗａｒｄｓ分级，分为四级。术前应用硝普钠静点，可降低肺血管阻力。作者重点介绍了各种类型室缺的手术适应证和修复方法，合并严重肺动脉高压的围手术期处理以及合并畸形的矫正和并发症防治。

FromJune1964toJune1993,2169patientswithventricularseptaldefect(VSD)includ-ingperimembranousVSD(1520),subpulmonary(VSD),VSDbeneathtricuspidseptalleafletin249pa-tients:muscularVSD(5),leftventricle-rightartriumcanalVSD(7),multipleVSD(8)underwentsurgi-caltreatment.Of271patientsassociatedwithseriouspulmonaryhypertension,51patientshadpul-monarytissuebiopsyduringoperationandpulmonaryvesselsweregraded.IndicationsfortheoperationofVSD,preventionofcomplicationandmanagementofassociatedlesionswerediscussed.