室间隔缺损并二尖瓣返流的病因及预后分析

Cause and prognosis of interventricular septum defect with complicated mitral regurgitation in children

目的 探讨小儿室间隔缺损(VSD)并二尖瓣返流(MR)的病因及预后。方法 应用HP-500或2000型超声心动图常规探查,明确有无VSD。确诊后应用二维超声、脉冲多普勒叠加彩色血流多切面探查二尖瓣口有无异常返流信号。结果 1787例单纯VSD患儿中233例并MR,其中82.0％有反复呼吸道感染,且感染次数越多,MR程度越重;9.9％VSD患儿二尖瓣存在先天性发育异常;VSD越大,重度MR者越多;手术者MR消失率(78.3％)较非手术者(37.4％)明显提高(P<0.001)。结论 反复感染、瓣膜先天性病变、大的左向右分流与VSD和并发MR密切相关;适时关闭VSD或修补瓣膜可改善患儿预后。

Objective To explore the causes and prognosis of interventricular septum defect (VSD) with complicated mitral re-gurgitation (MR) in children. Methods MR was detected by 2-dimensional echocardiography. Results MR was done in 233 cases out of 1787 children with VSD, in which 191 cases (82.0 % ) had recurrent respiratory infection. The more serious the MR , the more the respiratory infection . Congenital mitral valve malformation existed in 9. 9 % VSD children with MR. Furthermore, the larger the VSD size, the more serious the MR. The MR disappeared rate in operated patients (78.3 % ) was higher than that of non-operated patients (37.4 % ). Conclusions There was closely relationship between VSD with MR and recurrent respiratory infection , congenital mitral valve malformation, larger from left to right shunt. Repair of VSD and mitral valve could improve the prognosis of VSD children with MR.