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目的总结1018例婴幼儿行先天性心脏病(以下简称先心病)外科治疗的经验,探讨提高婴幼儿外科手术成功的方法和婴幼儿先心病的适当手术时机。方法对1992年12月至2004年7月间1018例3岁以内婴幼儿先天性心脏病外科治疗进行总结。1018例中男性613例占60.2%,女性405例占39.8%。年龄39h～36个月,平均(14.3±10.3)个月,其中新生儿8例(0.8%),婴儿514例(50.5%),幼儿496例(48.7%)。体质量(2.3～18.5)kg,平均(8.6±2.9)kg。术前反复发生呼吸道感染183例占16.8%。本组病人非紫绀型819例占80.5%,紫绀病人199例占19.5%。1018例病人非直视手术87例占8.6%,体外循环下直视手术931例占91.4%。结果住院死亡58例,死亡率5.7%。不同年龄段住院死亡率分别为:新生儿为50%,婴儿为9.6%,幼儿2.7%。不同体重死亡率分别为<5kg者15.3%,5～10kg者6.2%,11～15kg者2.1%,>15kg者无死亡。术后并发症发生率14.85%(150例),呼吸系统并发症占并发症的41.3%,循环系统占34.0%,其他并发症有切口感染、肺高压危象以及肝、肾功能不全等。出院的960例病人,758例获得随访,随访率78.5%,随诊时间2个月～10年6个月;晚期死亡1例,原因不明;室缺残余漏(VSD)6例,其中3例再次手术治疗,另3例因分流量小仍在观察中;智力障碍1例,为脑缺氧后遗症,慢性心力衰竭1例系法?
Objective To summarize the experience of surgical treatment of congenital heart disease (CHD) in 1018 infants and young children, and discuss the methods to improve the success of infant surgery and the timing of appropriate surgery in infants with CHD. Methods Surgical treatment of congenital heart disease in 1018 infants under 3 years old from December 1992 to July 2004 was summarized. Among 1018 cases, 613 were male, 60.2% were male, and 405 were female, accounting for 39.8%. The average age ranged from 39h to 36 months, with an average of (14.3 ± 10.3) months, including 8 newborns (0.8%), 514 infants (50.5%) and 496 infants (48.7%). Body weight (2.3 ~ 18.5) kg, with an average (8.6 ± 2.9) kg. Recurrent respiratory tract infection in 183 cases accounted for 16.8%. This group of patients with non-cyanotic 819 cases accounted for 80.5%, 199 cases of cyanosis accounted for 19.5%. 87 cases of non-direct-viewing surgery accounted for 8.6% in 1018 patients, and 931 cases of open-ended surgery under cardiopulmonary bypass accounted for 91.4%. Results 58 cases of hospitalized deaths, the mortality rate of 5.7%. In-hospital mortality rates were 50% for newborns, 9.6% for infants, and 2.7% for infants. Different body weight mortality were 15.3% <5kg, 5 ~ 10kg were 6.2%, 11 ~ 15kg were 2.1%,> 15kg no death. The incidence of postoperative complications was 14.85% (150 cases), respiratory complications accounted for 41.3% of complications, circulatory system accounted for 34.0%, other complications were incision infection, pulmonary hypertension crisis and liver and renal insufficiency. The discharged 960 patients, 758 cases were followed up, the follow-up rate was 78.5%, followed up for 2 months to 10 years and 6 months; late death in 1 case, unknown cause; ventricular residual leak (VSD) in 6 cases, of which 3 cases Again surgery, and the other 3 cases due to small flow is still under observation; mental retardation in 1 case, cerebral hypoxemia sequelae, 1 case of chronic heart failure Department of law?