婴儿大型室间隔缺损早期手术及围术期治疗

Early surgical management and perioperative treatment in infants with large ventricular septal defects

目的 探讨婴儿大型室间隔缺损（VSD）早期手术治疗、手术时机及围术期处理.方法 2011年3月至2014年8月,宿迁市儿童医院早期手术治疗31例大型VSD婴儿（其中4例术前在呼吸机支持下）.结果 31例婴儿手术成功,脱离呼吸机出院.术后主要并发症有肺不张、气胸、肺动脉高压危象及严重低心排.结论 把握手术时机和适应证,注重术中心肌保护、术后呼吸管理及其他综合治疗,早期手术可改善大型VSD治疗效果和预后。

Objective To study the results of early surgical treatment, surgical timing and perioperative treatment in infants with large ventricular septal defects（VSD）. Methods From March 2011 to August 2014, early surgical treatment of 31 babies with large VSD（4 of which had been preoperatively with ventilator support） were analyzed. Results All of the 31 cases of surgery were success. The postoperative complications were atelectasis, pneumothorax, tracheal intubation again, pulmonary hypertension crisis and low cardiac output syndrome. Conclusion Early surgery could improve the therapeutic effect and prognosis of children with Large VSD. As long as we grasp the surgical timing and indications, pay attention to perioperative treatment.