婴幼儿室间隔缺损心内直视术后心律失常的观察

Observations of postoperative arrhythmia of ventricular septal defect in infants

目的 探讨 3岁以内婴幼儿室间隔缺损 (室缺 )术后心律失常的发生特点及有效观察。方法 对 1990年 1月～1998年 12月的 389例婴幼儿室缺术后心律失常的发生情况 ,进行总结分析。分析其与年龄、术前心胸比值 (C/T)、合并肺动脉高压、室缺大小、手术方式及主动脉阻断时间的关系。结果 389例中心律失常 30例 ,发生率为 7.7%。年龄≤ 1岁 ,C/T≥ 0 .5 ,合并肺动脉高压 ,室缺≥ 1cm ,手术为补片修补 ,主动脉阻断时间≥ 30min为高危因素 ,是手术的主要死亡原因 ,本组死亡 9例 ,死亡率为 2 .3%。婴幼儿室缺心内直视修复术后心律失常的发生与年龄、术前C/T、合并肺动脉高压、室缺大小、主动脉阻断时间、手术方式相关。结论 对高危因素的婴幼儿应是观察的重点 ,有针对性的进行观察 ,及时采取有效防治措施 ,可降低手术后心律失常的发生率 。

ObjectiveTo explore the characteristics in occurrence of postoperative arrhythmia in less than 3 years old infants. MethodsA retrospective study was conducted in 389 infants to summarize and analyze the occurrence. The relations of it with age, C/T values before operation, pulmonary hypertension, operative method, diameter of VSD and the time of Aorta block were studied.ResultsAmong them, 9 died (2.3%) and 30 (7.7%) developed into arrhythmia. The factors leading to infant deaths included: age≤1,C/T≥0.5, φ≥1cm, higher pH values and time of Aorta block ≥30min. ConclusionsPostoperative infants with those dangerous factors should be put under close observation so as to decrease postoperative implications and enhance the acceptability to major operation.