室间隔缺损术后残余漏的发生原因及处理

摘要

1454 patients of VSD were repaired,RS 65 cases (4.5%). Simple VSD1152 cases, RS 38 cases (3.3%). VSD as a concomitant heart abnormality 302 cases,in which TOF 201 cases,RS 13 cases (6.5 %). All of 65 patients,reoperation for repair of the residual shunt was performed in 27 cases,spontaneous closure occurred in 9 cases,the residual shunt became smaller in 24 cases and unchanged in 5 cases. Three patients died. This suggested the patients with large VSD(＞8mm)should be repaired with patch. Significant residual shunt(＞5mm)should be early reoperated. Improvement of the repair skills is the key to prevention of residual shunt.%回顾1454例室间隔缺损修补术后65例(4.5％)残余漏的发生及转归。其中单纯室间隔缺损(VSD)1152例，术后残余漏38例(3.3％)；合并VSD的302例中，法乐氏四联症(TOF)201例，残余漏13例(6.5％)。本组65例残余漏患者中，二次手术修补27例(3例死亡)，自行闭合9例，缩小24例，无变化5例。认为室间隔缺损＞8mm者应补片修补，残余缺损＞5mm者宜早期手术治疗，＜5mm者可随访；提高手术技术是预防残余漏发生的关键。