372例婴儿室间隔缺损修补术治疗体会

Experience of Ventricular Septal Defect Repair in 372 Infants

目的总结372例婴儿室间隔缺损修补术的临床经验。方法行婴儿室间隔缺损修补术372例,术前合并难以控制的肺炎、心力衰竭,应用呼吸机并亚急诊手术8例。术中直接缝合26例,补片缝合346例。术后应用呼吸机辅助呼吸及抗炎、强心利尿、降肺动脉压治疗。结果围术期死亡4例,其中肺部感染2例,窒息2例,病死率1.08%。余均治愈出院。术后出现残余分流6例。术后应用呼吸机4～480 h,平均(32.0±10.2)h。术后合并呼吸道感染102例,其中肺炎48例。无远期传导阻滞发生。结论婴儿期室间隔缺损修补术治疗难度较大,但仍为治疗婴儿重症室间隔缺损的首选方法。

Objective To summarize the clinical experience of ventricular septal defect repair in 372 Infants.Methods 372 infants were treated by ventricular septal defect repair.Before surgery,8 cases were treated with respirators and subemergent surgery for unmanageable combined pneumonia and heart failure.In the intraoperative period,26 cases were treated by direct suture and 346 cases were treated by patch suture.After surgery,treatments including respirators to assist respiration,anti-inflammation,enhancing heart function,promoting urination and reducing the pressure of pulmonary artery.Results 4 cases died in the perioperative period,pulmonary infection in 2 cases and 2 cases of suffocation with the fatality rate being 1.08%.After surgery,residual shunts appeared in 6 cases.After surgery,respirators were used for 4 to 480 hours with an average of（32.0±10.2）h,and 102 cases of combined respiratory infection,48 of which were pneumonia.No future blocks occurred.Conclusion Ventricular septal defect repair was difficult to be conducted in infants,but it was still the first choice to treat severe ventricular septal defect in infants.