【摘 要】
：
目的:观察先天性心脏病膜周部室间隔缺损(P-VSD)的自愈性闭合(SC)情况,探讨P-VSD的治疗时机.方法 :选取经超声心动图确诊为单纯P-VSD的患儿112例(平均年龄4.7 d),根据有无膜
【机 构】
：
河北医科大学第一医院心脏中心, 石家庄,050031050000,石家庄市妇产医院/石家庄市第四医院东产二科;050000,石家庄市妇产医院/石家庄市第四医院超声科;050000,石家庄市妇产医院/石
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目的:观察先天性心脏病膜周部室间隔缺损(P-VSD)的自愈性闭合(SC)情况,探讨P-VSD的治疗时机.方法 :选取经超声心动图确诊为单纯P-VSD的患儿112例(平均年龄4.7 d),根据有无膜部瘤形成分为膜部瘤形成组(n=59)和无膜部瘤组(n=53).所有患儿在入选、出生1个月、出生6个月时行超声心动图检查,之后每半年检查1次,随访至6周岁,观察6年内P-VSD的SC率和SC时间.结果 :P-VSD患儿6年内发生SC者共64例,其中≤3岁者52例,占≤3岁患儿的46.43％,>3岁者12例,占>3岁患儿的25.00％,3岁以前发生SC的情况较多.所有发生SC的患儿缺损大小平均为(3.9±1.5)mm,SC率为57.14％,SC时间为(2.3±1.5)岁,其中膜部瘤形成组49例,缺损大小平均为(4.0±1.5)mm,SC率83.05％,SC时间为(2.4±1.5)岁;无膜部瘤组15例,缺损大小为(3.5±1.2)mm,SC率28.30％,SC时间为(2.0±1.4)岁.膜部瘤形成组SC率显著高于无膜部瘤组(P<0.05).26例P-VSD患儿在随访期间接受了手术闭合治疗,其中膜部瘤形成组7例,无膜部瘤组19例,接受手术治疗的患儿缺损明显大于发生SC的患儿[(6.2±1.0)mm对(3.9±1.5)mm,P50％,有膜部瘤形成的P-VSD患儿较易发生SC;缺损较大的P-VSD患儿SC率较低,建议手术治疗.
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