儿童室间隔缺损合并动脉导管未闭的外科治疗

Surgical Treatment of Ventricular Septal Defect with Patent Ductus Arteriosus in Children

目的:介绍儿童室间隔缺损合并动脉导管未闭,在诊断及手术处理方面的特殊性。方法:总结我院1986～1997年11年间,共手术治疗室间隔缺损合并动脉导管未闭52例,除1例合并主动脉缩窄采取分期手术外,其余均同期手术矫治。结果:无手术死亡。合并动脉导管未闭术前漏诊率9.4%,合并肺动脉高压者较多见,女性病例是男性的2倍。结论:对室间隔缺损并动脉导管未闭,宜采取一期手术。并存的动脉导管常较小,手术时不必深低温、微流量转流。同期手术并不增加病死率。

Objective:To review the experience in management of ventricular septal defect (VSD)with patent ductus arteriosus(PDA)in children.Methods:From 1986 to 1997,52 pa- tients(male to female ratio 2:1)of VSD with PDA underwent surgical correction.Most of them were associated with pulmonary hypertension.One case also suffered from coarctation of aorta and repaired by two-stage.The remaining had single-stage repair of both leisions via median sternoto- my.Results:There was no mortality.The misdiagnosis rate was 9.4%.Conclusions:To most of the accompanying small PDA,single-stage operation on VSD and PDA is recommended.Hy- pothermia and low flow bypass seem not necessary for the operation.