小儿室间隔缺损的超声心动图随访研究

Study on Ultrasonic Cardiography Follow-up of Children with Ventricular Septal Defect

目的:通过超声心动图随访并分析评价小儿室间隔缺损(VSD)自然愈合(SC)情况及影响因素。方法:125例VSD患儿,其中膜周部87例(69.6%),肌部20例(16.0%)、漏斗部18例(14.4%),心功能正常66例,心功能不全59例。应用超声心动图分别给予3或6个月一次的随访监测,调查VSD患儿自然愈合情况,并分析其年龄、缺损部位、直径、心功能、左室大小情况。结果:125例VSD患儿自然愈合44.8%(56/125),患儿年龄3个月~11岁,平均(2.3±1.6)岁,56例患儿中,7岁以内有87.5%(49/56);膜周部73.2%(41/56),肌部26.8%(15/56),漏斗部0(0/56);其中缺损直径≤5 mm有75.0%(42/56),直径>5 mm有25.0%(14/56)。左心室大小正常者73.2%(41/56),心功能正常者80.4%(45/56)。结论:心功能正常、缺损直径≤5 mm、位于膜周部或肌部、左心室内径正常的VSD患儿自然愈合的可能性较大,临床超声随访年龄建议可至7岁。

Objective：To analyse the factors related to spontaneous closure（SC） situation in ventricular septal defects（VSD） children by echocardiography.Method：A total of 125 VSD children were examined by echocardiography,87 cases（69.6%） of perimembranous VSD,20 cases（16.0%） of muscular VSD and 18 cases of（14.4%） infundibular VSD.There were 66 cases of normal heart function and 59 cases of cardiac function insufficiency.The children were given the 3 or 6 months measured by echocardiography.Observed the situation of spontaneous closure with ventricular septal defects（VSD） and analyzed the relationship between spontaneous closure and VSD location,the defect site,the age,the heart function and the size of left ventricular.Result：44.8%（56/125） VSD children were spontaneous closure.The children were from 3 months to 11 years old,the mean age was（2.3±1.6） years old.87.5%（49/56） under 7 years old.Among the 56 cases,73.2%（41/56） with perimembranous VSD,and 26.8%（15/56） with muscular VSD,infundibular VSD was 0（0/56）;75.0%（42/56） which defect size was less than 5 mm and 25.0%（14/56） which defect size was greater than 5 mm in SC cases.The rate of normal size of left ventricular was 73.2%（41/56） in SC cases,and patients without CHF was 80.4%（45/56）.Conclusion：The children with the VSD without congestive heart failure,the VSD diameter≤5 mm,site in perimembranous and muscular,normal size of left ventricular would have a higher possibility of spontaneous closure of VSD.The age of children with the VSD using echocardiography studied should follow-up to 7 years old.