婴儿心脏畸形矫治手术128例报告

Surgical Management of Congenital Heart Disease in Infants

目的：探讨婴儿先天性心脏畸形的手术矫治效果。方法：分析总结我院外科１９９４年６月至１９９５年１０月间连续对１２８例先天性心脏畸形婴儿手术矫治情况。结果：１２８例婴儿，年龄９．１±２．７（２～１２）月；体重７．０±１．６（４～１２）ｋｇ。６６例左向右分流心脏畸形，包括：心室间隔缺损３７例、心室间隔缺损合并动脉导管未闭和（或）心房间隔缺损１５例、心室间隔缺损合并二尖瓣关闭不全５例、动脉导管未闭６例、其他３例，其中合并中重度肺动脉高压４７例。紫绀型右向左分流心脏畸形６２例，包括：法乐四联症４１例、法乐三联症６例、心室间隔缺损合并肺动脉狭窄２例、复杂心脏畸形１３例。１２８例中６例动脉导管未闭在全麻下行闭合术，余１２２例婴儿均在中度或深度低温体外循环下行心内矫治术，手术死亡４例，手术死亡率３．１２％。结论：先天性心脏畸形在婴儿期行矫治手术。

Objective:To study the corrective results of infants with congenital heart disease. Methods:Review and analyse the corrective operation performed on 128 infants with congenital heart diseases from June 1994 to October 1995. Results:The average age of the 128 infants was 9.1±2.7(2～12)months,and the average weight 7 0±1.6(4～12) kg.Sixty six patients were congenital heart disease with left to right shunt including 37 cases of simple VSD;15 of VSD with PDA and (or)ASD;5 of VSD with MI;6 of PDA;and 3 of other kinds of congenital heart disease.Among them 47 infants had pulmonary hypertension.Sixty two infants had cyanotic congenital heart disease,including 41 cases of TOF;6 of ASD with PS;2 of VSD with PS and 13 of cyanotic complex cardiac lesions.Six infants with simple PDA underwent ligation or division and suture under normal temprature without CPB,122 patients were operated under hypothermic CPB.Four patients died postoperatively and the overall mortality was 3.12%. Conclusion:The corrective surgery for infants with congenital heart diseases may have satisfactory results,with careful preoperative preparations,precise surgical and perfusion techniques,adequate correction of the associated cardiac anomalies and intensified postoperative cares.