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目的探讨婴幼儿室间隔缺损(VSD)合并肺动脉高压(PH)外科治疗预后的影响因素。方法 32例VSD合并PH的婴幼儿,在中低温下行VSD修补术,术前给予患儿间断或持续吸氧,术中加强麻醉及体外循环管理,术后合理使用呼吸机辅助呼吸,同时加强呼吸道管理,术后应给予强力抗生素控制感染,并适时应用血管活性药物。结果 32例VSD合并PH婴幼儿术后因肺部感染、呼吸循环衰竭死亡1例,余肺不张2例,肺炎3例,低心排2例,胸腔积液1例,经治疗后均痊愈出院,随访6~12个月,患儿生长发育明显改善,无远期并发症及死亡。结论全面的围手术期处理是VSD合并PH患儿治疗效果的重要保障措施。
Objective To investigate the influencing factors of prognosis of infantile ventricular septal defect (VSD) combined with pulmonary hypertension (PH). Methods 32 cases of VSD with PH in infants and young children underwent VSD repair at low to moderate temperature. The patients were given intermittent or continuous oxygen inhalation before surgery. During the operation, anesthesia and cardiopulmonary bypass were strengthened. Ventilator was used to assist breathing after operation, Management, postoperative antibiotics should be given to control infection, and timely application of vasoactive drugs. Results 32 cases of VSD with PH infants after surgery due to pulmonary infection, respiratory failure, death in 1 case, more than 2 cases of atelectasis, pneumonia in 3 cases, 2 cases of low cardiac output, pleural effusion were cured after treatment were cured Discharged, followed up for 6 to 12 months, children with significantly improved growth and development, no long-term complications and death. Conclusion The comprehensive perioperative management is an important safeguard for VSD with PH.