新生儿心内直视手术10例

Intracardiac surgery in neonates

目的 :报告 10例新生儿心内直视手术 ,总结其经验与教训。方法 :新生儿先天性心脏病 (先心病 ) 10例 ,术时日龄 7～ 2 7(19± 4) d,体质量 2 .7～ 4.2 (3.5± 1.4) kg。病种为法乐氏三联症 1例 ,完全性大动脉转位 1例 ,室间隔缺损8例。并发房间隔缺损 7例 ,动脉导管未闭 2例 ,肺动脉高压 5例。 8例有肺炎或 (和 )心力衰竭史。均在全麻体外循环下行根治术。结果 :早期死亡 3例 ,存活 7例。随访 5～ 19(17± 3)月。患儿发育良好 ,心前区杂音消失 ,未见并发症。结论 :新生儿先心病手术治疗可获较好治疗效果。

AIM: To review the experience of intracardiac surgery in neonates. METHODS: Ten neonates with congenital heart disease underwent radical operation. The age at operation ranged from 7 d to 27(19±4) d.The body weight ranged from 27 kg to 4.2 (3.5±1.4)kg. The diagnosis was trilogy of Follot in 1 patient,complete transposition of the great arteries with intact ventricular septum in 1,ventricular septal defect in 8. The concomitant deformations included atrial septal defect in 7 patients, patent ductus arteriosus in 2, pulmonary hypertension in 5. Eight patients had the history of pneumonia or/and heart failure. RESULTS:There were 3 early deaths. The causes of death were pulmonary hypertension crisis , perfusional lung and respiratory failure respectively. Seven survivors were followed up 5~19(16.8±3.4) mo and all of them recovered smoothly without any complication. CONCLUSION:With the skilled and standardized surgical techniques and postoperative monitoring and management,the surgical treatment of congenital heart disease in neonates may expect a good result. It is feasible to develop the intracardiac surgery in neonates step by step.