39例大型房间隔缺损 室间隔缺损并发肺炎婴儿早期手术治疗的临床分析

李步云, 杨一峰, 吴忠仕, 赵天立, 杨进福, 熊炼, 尹倪, 谢立

中国当代儿科杂志 ›› 2008, Vol. 10 ›› Issue (3) : 315-318.

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中国当代儿科杂志 ›› 2008, Vol. 10 ›› Issue (3) : 315-318.
临床研究

39例大型房间隔缺损 室间隔缺损并发肺炎婴儿早期手术治疗的临床分析

  • 李步云,杨一峰,吴忠仕,赵天立,杨进福,熊炼,尹倪,谢立
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Early surgical treatment for infants with large atrial septal defects or ventricular septal defects complicated by pneumonia: experience of 39 cases

  • LI Bu-Yun, YANG Yi-Feng, WU Zhong-Shi, ZHAO Tian-Li, YANG Jin-Fu, XIONG Lian, YIN Ni, XIE Li.
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摘要

目的:婴儿大型房间隔缺损(ASD)室间、隔缺损(VSD)难以自愈,需要尽早手术纠治,以免影响发育甚至导致死亡。但是这类患儿往往并发严重的肺部感染,且反复发作,很难等到肺部感染完全治愈时进行手术纠治。同时患儿需要反复治疗肺炎,费用较高且易延误手术时机。因此,该文研究婴儿大型房间隔缺损、室间隔缺损并发肺炎的早期手术治疗的手术时机选择、治疗的可行性以及减少并发症的处理。方法:2003年1月至2008年 1月,收治大型ASD, VSD并发肺炎39例婴儿,36例在肺炎控制后进行早期手术治疗,3例再行儿科保守治疗。结果:手术病例中, 33例婴儿手术成功, 2例婴儿死于气管狭窄, 1例死于严重低心排, 死亡率8.3%。儿科保守治疗病例中,1例在治疗中因心肺衰竭死亡 ;2 例好转出院,择期行手术治疗成功。结论:把握手术时机和适应证,做好围术期处理,在肺炎控制后对大型ASD,VSD的婴儿进行早期手术治疗是可行的,可提高和改善治疗效果并减少患者费用

Abstract

OBJECTIVE: This research reported the experience of early surgical treatment for infants with large atrial septal defects (ASD) or ventricular septal defects (VSD) complicated by pneumonia.METHODS: Between January 2003 and January 2008, 39 infants with large ASD or VSD complicated by pneumonia were admitted to the Second Xiangya Hospital. Thirty-six patients underwent surgical repair within 7-10 days after pneumonia had been controlled. Mean age was 5.4±3.4 months and mean weight was 4.7±1.6 kg in the 36 patients. Three patients received conservative treatment due to uncontrolled lung infections.RESULTS: Of the 36 patients, 33 had successful surgery and 3 (8.3%) died of serious low cardiac output (n=1) or respiratory failure due to congenital tracheostenosis (n=2). The 33 survivors showed normal growth and development in a 6 month-5 year follow-up. Of the 3 patients receiving conservative treatment, 1 died of cardiopulmonary failure and 2 were discharged after the symptoms had been improved. CONCLUSIONS: With increasing medical experience and technique, early surgical operation may be performed with good outcomes in infants with large ASD or VSD complicated by pneumonia.

关键词

房间隔缺损 / 室间隔缺损 / 肺炎 / 外科手术 / 婴儿

Key words

Atrial septal defects / Ventricular septal defects / Pneumonia / Surgery / Infant

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导出引用
李步云, 杨一峰, 吴忠仕, 赵天立, 杨进福, 熊炼, 尹倪, 谢立. 39例大型房间隔缺损 室间隔缺损并发肺炎婴儿早期手术治疗的临床分析[J]. 中国当代儿科杂志. 2008, 10(3): 315-318
Li-Bu-Yun, YANG Yi-Feng, WU Zhong-Shi, ZHAO Tian-Li, YANG Jin-Fu, XIONG Lian, YIN Ni, XIE Li. Early surgical treatment for infants with large atrial septal defects or ventricular septal defects complicated by pneumonia: experience of 39 cases[J]. Chinese Journal of Contemporary Pediatrics. 2008, 10(3): 315-318
中图分类号: R725.4   

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