室间隔膜部瘤的临床研究——附31例假性室间隔膜部瘤的分析

Aneurysm of membranous septum (AMS) in ventricular septal defect —operative outcome in 31 cases of ventricular septal defect complicated with false aneurysm of membranous septum

目的：研究真性、假性室间隔膜部瘤的诊断和外科治疗及其疗效。方法：１９８４１９９８ 年本院全组真性或假性室间隔膜部瘤手术３９ 例，从病因学、病理解剖学、术前ＵＣＧ 检查、术中所见几方面进行比较，对全部３１ 例假性室间隔膜部瘤患者进行术后随访。结果：假性室间隔膜部瘤诊断从病因学、病理解剖学、术前ＵＣＧ 检查、术中所见等均可确立。术前诊断主要手段是ＵＣＧ。术中所见最后确定真性和假性膜部瘤，并采用不同的手术方法。全部手术治疗无死亡，无合并症。术后对３１ 例假性膜部瘤患者随访６ ～１５ 年（平均１１．６ 年），近期、远期疗效均满意。全部恢复正常人生活。结论：（１）术前、术中鉴别出假性膜部瘤对手术治疗有指导意义；（２） 对假性室间隔膜部瘤应采用改进的手术方法，其疗效是满意的。

Objective: To study the diagnosis, surgical treatment and outcomes of the aneurysm of membranous septum (AMS) in ventricular septal defect (VSD). Methods: 39 cases entered the whole group from 1984 to 1998. Their etiology, pathoanatomy, pre operative UCG and operation findings were compared. The post operative follow up was made in 31 cases of false AMS. Results: False AMS in VSD could be diagnosed with etiology, pathoanatomy, pre operative UCG and operation findings. UCG was the dominant examination method. Operation findings determined the true or false AMS, and different operation methods were carried out afterwards. There were no death, no complication, residential leakage, A V block, tricuspid insufficiency, and aortic insufficiency. The follow up was made in 31 cases of AMS in VSD from 6 15 years (mean 11.6 years). The satisfactory results showed in short and long term outcomes. All patients returned to their normal lives. Conclusion: AMS in ventricular septum consists of true type and false type. Diagnosis could be made pre and mid operatively. All the 31 cases of false AMS in VSD were operated on with modified surgical method, and the outcome was satisfactory and definite.