先天性心脏病室间隔缺损的诊治分析

Study on diagnosis and treatment in 450 children with ventricular septal defect of congenital heart disease

目的总结先天性心脏病室间隔缺损(VSD)的诊断、治疗方法及效果。方法研究450例经体格检查以及心电图(ECG)、X线胸片、经胸超声心动图(TTE)及心导管造影检查明确诊断的VSD,根据适应证选择介入封堵治疗或体外循环下直视修补手术后进行动态的随访观察。结果238例采用介入封堵治疗,技术总成功232例,成功率97.48%;6例未成功,有并发症7例(2.94%),无死亡患者。218例采用体外循环下直视修补手术,有并发症63例(29.72%),死亡5例(2.36%)。结论VSD的诊断主要依靠TTE,诊断困难者需心导管造影检查。VSD介入封堵治疗及体外循环下直视修补手术两种方法,各有其优缺点,应严格掌握适应证。介入封堵治疗近期效果满意,远期疗效尚需进一步观察。

Objective To study the diagnosis and treatment in 450 Children with ventricular septal defect. Methods 450 children with ventricular septal defect, they were all diagnosticed with ECG, X - ray chest, TTE and contrast examination. The treatment effects by interventional and cardiopulmonary bypass were compared. Results 232 out of 238 children treated with intervention were succeed （97.48%）, 6 children were failed, there are 7 children have complication （2.94%）, 218 children treated with cardiopulmonary bypass, 63 children had complication （29. 72% ）, and 5 children were dead （2. 36% ）. Conclusion The treatment of intervention and cardiopulmonary bypass has its shortcoming and merit, but intervention merit is outweigh cardiopulmonary bypass in the near future.