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目的总结婴儿大型室间隔缺损(VSD)合并肺动脉高压的外科治疗经验,探讨早期手术时机、适应证和围手术期处理问题。方法对婴儿大型VSD合并肺动脉高压60例(VSD膜周型46例,肺动脉瓣下型14例),均在全麻及体外循环下行一期根治术。结果术后无死亡,所有患儿均痊愈出院。随访所有患儿活动量和生长发育改善,呼吸道感染明显减少,无后遗症。结论早期手术治疗可提高和改善婴儿大型VSD多合并肺动脉高压的治疗效果和预后,完善围手术期管理是降低并发症、减少病死率的关键。
Objective To summarize the experience of surgical treatment of large ventricular septal defect (VSD) complicated with pulmonary hypertension in infants and to discuss the timing, indications and perioperative management of early surgery. Methods Sixty infants with large pulmonary hypertension (VSD 46 cases, 14 cases under the pulmonary valve) underwent primary gastrectomy and cardiopulmonary bypass. Results no death after surgery, all children were cured and discharged. All children were followed up for activity and growth and development improved, respiratory infection was significantly reduced, no sequelae. Conclusion Early surgical treatment can improve and improve the therapeutic effect and prognosis of large-scale VSD combined with pulmonary hypertension in infants. To improve perioperative management is the key to reduce complications and reduce mortality.