婴幼儿先天性心脏病外科治疗268例分析

Analysis of the surgical treatment for congenital heart disease in 268 infants.

目的总结婴幼儿先天性心脏病的外科治疗经验。方法回顾性分析2006年7月至2009年8月本院外科收治的268例婴幼儿先天性心脏病患儿的临床资料。年龄1～36个月，平均年龄（17．21±9．41）个月，其中年龄≤6个月53例；7～12个月82例；13～36个月133例。体重3．2—15．0kg，平均体重（9．12±2．45）kg，其中体重≤10kg者172例。采取根治性手术260例，姑息性手术8例。结果全组治愈262例，治愈率为98％，均获随访，随访时间1—36个月，随访期间无一例死亡，患儿生长发育良好。死亡6例，死亡率为2．2％，其中1岁以内死亡4例，占1岁以内患儿的2．96％，死亡原因为心、肾功能衰竭。出现并发症14例（5．2％），包括急性呼吸窘迫综合症3例，低心排出量综合征4例，急性肾功能衰竭3例，严重心律失常4例（其中2例为Ⅲ°-AVB），室间隔残余分流3例。结论婴幼儿先天性心脏病采取手术治疗可以取得满意疗效，准确把握手术适应症以及符合婴幼儿生理特点的围术期处理是手术成功的关键。

Objective To review the clinical experience of the surgical treatment of congenital heart disease （CHD）in infants. Methods From July. 2006 to Aug. 2009,268 infants （141 males,121 females） underwent operations for their CHD. Their ages ranged from 1 to 36 months（17. 21 ±9.41 months）. 53 eases less than 6 months, g2 cases between 7 to 12 months.Their body weight ranged from 3.2 to 15 kg （9.12 ± 2.45kg）. The body weight of 172 cases were less than 10kg. 260 patients underwent one-stage radical operation. 8 cases underwent palliative approach. Results There were 6 deaths,with operative mortality of 2.2%. Conclusions The satisfactory result can be acquired in infantile operation of CHD. The operation successful keys are the choice of proper operation way and time.Postoperative intensive care are very important also.