摘要
目的 探讨室间隔缺损(VSD)手术时机、修补方法及补片材料的选择.方法 在低温体外循环下连续手术治疗VSD 416例,其中男257例,女159例;年龄40天～46岁,平均4.7±3.4岁,其中婴幼儿235例(56.5%);体重3～80kg,平均14.6±11.5kg,10kg以下者187例(45%).直视缝合307例,新鲜自体心包片修补64例,涤纶片修补44例,毡片修补1例,补片修补均采用全周连续缝合;隔瓣后缺损显露不清楚者,可切开隔瓣或切断园锥乳头肌.结果 术后30天内死亡6例(1.4%),主要并发症发生率8.4%.结论(1)VSD手术时机主张“三早”原则,即早发现、早诊断、早治疗.(2)正确地选择心脏切口,补片以全周连续缝合可节省手术时间,减少残余漏,即使不做超越或转移缝合也能避免Ⅲ°房室传导阻滞.(3)新鲜自体心包片是修补VSD的良好材料.
Objective To investigate the time, the method and the select of patch materials in the repair of ventricular septal defect (VSD). Methods From Dec. 1992 to Sep. 1999, 416 patients (male 256, female 159) were operated on for their VSD. Their ages ranged from forty days to forty-six years. The mean age was 4. 7±3. 4 years. Their body weight ranged from 3-80kg. The mean body weight was 14. 6±11. 5kg. 235 patients were younger than 3 years old(56. 5%). 172 patients were less than or equal to 10kg(45%). 307 patients were required with direct stitch closure and 109 with patch closure (64 using fresh autopericardium, 45 with Dacron patch). The continuous suture was used in all patch closure, the septal cusp was sheared and the conical papillary muscle was amputated when the defect exposure was unclear. Results The mortality was 1. 4% and the morbidity was 8. 7%. Conclusion (1) We advocate the principle for the operating time of VSD,that is early finding, early diagnosis and early treatment. (2) Proper insision, clear exposure of VSD and continuous stitch when using patches can shorten the operation time and reduce the morbidity, (3) The fresh autopericardium is good material for closing VSD.
出处
《中国心血管杂志》
2000年第4期209-211,共3页
Chinese Journal of Cardiovascular Medicine
