婴儿室间隔缺损修补术后早期处理

Early postoperative care in infants with ventricular septal defects

目的探讨婴儿室间隔缺损(VSD)修补术后早期防治各种并发症的措施。方法2006年6月至2008年6月,手术矫治婴儿VSD194例,男108例,女86例;年龄58d～12个月,其中6个月以下者72例;体质量2.8～8.5kg,其中3～5kg81例。超声心动图提示VSD直径5.0～16mm,平均(9.1±3.4)mm。均在浅低温体外循环心脏停跳下行VSD修补手术。术后早期加强处理,防治肺部感染、肺动脉高压、心功能不全、心律失常等并发症。结果全组无死亡。术后早期房室传导阻滞5例,肺部感染17例,肺不张8例,经积极治疗后愈;无肺动脉高压危象或心力衰竭发生。全组随访2～24个月,无特殊严重并发症发生。结论术后早期积极防治各种并发症是治疗婴儿VSD成功的重要保障。

Objective To review the experience of early postoperative care in infants with ventricular septal defects. Methods From June 2006 to June 2008,194 infants with VSDs,whose age ranged from 58 days- 12 months and whose weight ranged from 2. 8 to 8.5 kilograms, underwent surgical correction. The diameter of VSDs was 5.0 to 16 milimeters [ mean（9. 1 ± 3.4 ）millimeters ]. All infants were operated under mild hypothermic eardiopulmonary bypass and arresting heart. The complications of infection, arrhythmia, malnutrition, pulmonary hypertension or（and） heart failure were treated sufficiently in early postoperative stage. Results No ease died. Complications in early stage including 5 cases of arrhythmia, 17 cases of pulmonary infection and 8 eases of ateleetasis were all cured. No pulmonary hypertension crises or heart failure occurred. No other severe complications occurred in following up 2 - 24 months. Conclusion Early postoperative care makes great supportability for the success rate of VSD correction in infants.