婴幼儿室间隔缺损合并肺炎的诊治及手术时机探讨

To discuss the diagnosis,treatment and operation timing of ventricular septal defect complicated with pneumonia in infants

目的对婴幼儿室间隔缺损合并肺炎的诊治及手术时机的探讨。方法回顾2013年1月—2014年7月我院心脏科收治的室间隔缺损合并肺炎患儿32例,分析其临床诊治及手术资料,探讨合适的手术时机。结果 32例患儿中均易患肺炎,部分反复发生,其中5例室间隔缺损均在1.0 cm以上,年龄在6个月以下,肺炎较重,不易控制,且心功能不全控制不理想,故予早期手术治疗,3例痊愈出院,1例放弃治疗,1例死亡,其余27例患儿经积极抗感染、改善心功能不全及对症、支持治疗后,肺炎治愈,心功能不全控制,行择期手术,全部痊愈出院。结论婴幼儿室间隔缺损合并肺炎,大部分经内科保守治疗可痊愈而择期手术,但部分患儿因年龄小、缺损大、肺炎重,心功能不能控制时,应尽早进行手术治疗,降低死亡率,改善患儿生存质量,减轻家庭负担。

Objective To investigate the diagnosis,treatment and operation timing of ventricular septal defect complicated with pneumonia in infants.Methods To analyse the clinical diagnosis and the operation data of 32 cases of children with ventricular septal defect complicated with pneumonia which treatment in the Cardiology department of our hospital between January 2013 and July 2014,to explore the appropriate timing of the operation.Results 32 patients were susceptible to pneumonia, repeatedly occur,including 5 cases of ventricular septal defect were more than 1.0cm,less than 6 months old,pneumonia is heavy,not easy to control,and the heart failure control is not ideal,therefore,to give the early operation treatment,3 cases were cured,1 cases gave up treatment,1 patients died,the other 27 cases with positive anti infection,improving cardiac dysfunction,cure pneumonia,the symptom controlled.Through the elective operation,27 patients recovered.Conclusion The most ventricular septal defect in infants with pneumonia can be cured by conservative treatment and underwent selective operation.But some patients because of the young age,defect,pneumonia,heart function can not control,operation treatment should be performed as early as possible,to improve the quality of life of patients and reduce the mortality rate and the family burden.