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目的 探讨婴幼儿室间隔缺损 (VSD)合并动脉导管未闭 (PDA)的外科治疗经验。方法 回顾性分析 44例VSD伴PDA婴幼病儿的临床特征、手术过程、围术期处理与转归。结果 婴幼儿VSD合并PDA者易早期产生重度肺动脉高压和心功能不全。手术死亡 2例 ,病死率 4 5 %。结论 VSD伴PDA婴幼病儿宜在 1岁前手术治疗 ,PDA可根据病情分期或一期手术 ,PDA恰当处理与术后转归关系密切 ,术后呼吸功能不全是死亡的主要原因。围术期应注意心功能保护 ,加强呼吸道管理及营养支持 ,预防和治疗肺动脉高压危象。
Objective To investigate the surgical treatment of infantile ventricular septal defect (VSD) combined with patent ductus arteriosus (PDA). Methods Retrospective analysis of 44 cases of VSD with PDA in infants with clinical features, surgical procedures, perioperative management and outcome. Results Infants and young children with VSD complicated with early easy to produce severe pulmonary hypertension and cardiac insufficiency. 2 cases died of surgery, the mortality rate 45%. Conclusion The treatment of VSD with PDA infants should be operated before the age of 1 year. The PDA can be staged or operated according to the disease stage. The appropriate treatment of PDA is closely related to postoperative outcome. Postoperative respiratory insufficiency is the main cause of death. Perioperative period should pay attention to cardiac function protection, strengthen respiratory management and nutritional support, prevention and treatment of pulmonary hypertension crisis.