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目的:探讨小儿先天性心脏病(CHD)部分性房室间隔缺损(PAVSD)的外科治疗方法,以期提高疗效。方法:对1999年6月至2009年8月收治27例PAVSD临床资料进行分析,男16例,女11例,年龄1.3～14岁,平均6.08岁。术前均经彩色多普勒超声心动图(Echo)和部分心导管检查确诊。手术全部在中低温体外循环(CPB)下行根治术。结果:无手术死亡。22例获1个月～10年随访,1例术后3个月因重度二尖瓣返流(MR),心力衰竭死亡,1例Ⅱ°房室传导阻滞(AVB)6个月后自行恢复,2例仍有轻度二尖瓣关闭不全;余生活、学习正常,心功能Ⅰ级。结论:一旦确诊应尽早手术治疗。修补原发孔缺损,注意避免损伤传导束,二尖瓣裂修复完善是手术成功和减少并发症的关键。
Objective: To investigate the surgical treatment of pediatric congenital heart disease (CHD) partial atrioventricular septal defect (PAVSD) in order to improve the curative effect. Methods: Clinical data of 27 cases of PAVSD admitted from June 1999 to August 2009 were analyzed. There were 16 males and 11 females, aged from 1.3 to 14 years, with an average of 6.08 years. Preoperative color Doppler echocardiography (Echo) and some cardiac catheterization confirmed. All operations underwent hypothermic cardiopulmonary bypass (CPB) radical surgery. Results: No operative death. Twenty-two patients were followed up for 1 month to 10 years. One patient had severe MR (mitral regurgitation) and died of heart failure 3 months after operation. One patient had AVB after 6 months. Recovery, 2 cases still mild mitral regurgitation; I living, learning normal, grade Ⅰ heart function. Conclusion: Once the diagnosis should be operated on as soon as possible. Repair of the primary hole defect, pay attention to avoid damage to the conduction beam, mitral valve repair repair is the key to successful surgery and reduce complications.