室间隔缺损的解剖学分型及其临床意义

The Anatomical Classification of Ventricle Septal Defects and Its Clinical Significance

目的探讨室间隔缺损解剖学分型的临床意义。方法按照Ｓｏｔｏ的分类方法略加改进，将３５０例室间隔缺损分为４种解剖学类型，并与其临床表现相对照。结果３５０例室间隔缺损中，７６％（２６６例）为膜周型，缺损均与室间隔膜部关连；１９．４％（６８例）为干下型，位于肺动脉与主动脉相遇的左右瓣环下；０．９％（３例）为肌部型，可见于肌部间隔的任何一处；３．７％（１３例）为混合型，包括单个大型缺损涉及室间隔多个部位或同时出现两种以上的单个室间隔缺损。结论室间隔缺损的解剖学分型对临床诊断及治疗有较高的价值。

Objective\ To demonstrate the clinical significance of the anatomical classification of ventricular septal defect(VSD).\ Methods\ According to the modified Soto′s classification 350 cases of VSD were divided into four anatomical types and the anatomical types compared with their clinical signs.\ Results\ In 350 cases of VSD,76%(266 caes) were perimembranous types. These defects were variably related to the membranous portion of interventricular septum;19.4%(68 cases)were subtrunk types. Whose defects were lying immediately beneath the pulmonary and aortic valves. 0.9%(3 cases) were muscular types with defects occurring anywhere in the muscular portion of interventricular septum.\ 3.7%(13 cases)were mixed types which included a large,single VSD involving more than one area of the septum and more than one defects occurring in the septum.\ The main clinical signs of each type of VSD were described in detail. The surgeon can choose appropriate incision and operative procedures accordingly.\ Conclusion\ The anatomical classification of VSD is valuable for their clinical diagnosis and treatment.