婴幼儿先天性心脏病的外科治疗

SURGICAL TREATMENT FOR INFANTS WITH CONGENITAL HEART DISEASES

对１１９例患先天性心脏病（先心病）患儿进行了手术治疗。男性７５例，女性４４例。法乐四联症、房室管畸形等复杂先心病５０例；大室间隔缺损合并严重肺动脉高压５３例，其中反复肺炎、心衰，用药物不能控制而进行亚急症手术２４例；其它１６例。主动脉阻断时间为１７～８３（３６．６７±１９．００）ｍｉｎ，体外循环时间为３６～４９３（７６．２０±３４．４２）ｍｉｎ。手术死亡５例（４．２％），其中室缺并严重肺动脉高压亚急症手术死亡率为８％。作者还对婴幼儿期心脏外科手术指征、心肌保护和低心排综合征的防治以及围手术期肺部并发症的防治等问题进行了讨论。

One hundred and ninteen consecutive infants with congenital heart diseases underwent corrective operation.Among them, 75 were male, 44 female.The age range was from 3 to 36 (13 7±8 9) months and the body weight was 5 to 12(7 5±2 5)kg.There were 50 cases of complex congenital heart diseases including tetralogy of Follot,atrioventricular canal deformity,double outlet right ventricle ,etc. Fifty three cases of ventricular septal defect with pulmonary hypertension,including 24 cases with repeated heart failure and pneumonia who underwent emergent operation.The mean aorta occlusion time was (36 67±19 00) min(17～83min).The extracorporal circulation time was 36 to 493 min .The operative mortality was 4 2% (5 cases).In patients with ventricular septal defect with pulmonary hypertension, the mortality was 8%. The indication, myocardial support and perioperative care in infants are discussed in the paper.