【摘要】 目的 :通过总结成人继发孔型房间隔缺损的外科治疗及预后 ,更好的掌握成人房间隔缺损的手术适应证 ;方法 :选择 2 0岁以上术前平均肺动脉压≤ 8kPa(6 0mmHg) ,左向右分流为主的 37例成人房间隔缺损病人均在体外循环下行直视修补术 ;结果 :全组死亡 1例 ,手术死亡率为 0 0 3% ,随访 32例 ,2 9例症状消失 ,3例尚有不同的临床症状 ;结论 :成人房间隔缺损 (ASD)病人有临床症状 ,X线胸片示C/T >0 5 ,肺充血明显 ,心电图示右室肥厚、电轴右偏或传导障碍 ,超声心动图提示房间隔缺损 1 5cm以上者应早手术治疗更多还原

【Abstract】 Objective:To summarize the clinical experience in surgical treatment and prognosis of artrial septal defect (ASD) in adults and to know well the surgical indication of ASD in adults.Method:37 patients over 20 years old with the left-to-right shunt and preoperative mean pulmonary artery pressure less than 8 Kpa (60mmHg) underwent direct surgical repair for ASD under extracorporeal circulation.Result:All patients but one survived after surgery,surgical mortality was 0.03% in our group.32 patients were followed-up,29 of them with disappearing symptoms and 3 of them still having various symptoms.Conclusion:The following condition ASD in adults who have slight to moderate clinical symptoms should be operated;cardiac enlargement (cardiothoracic ratio over 50%) and pneumonemia in X-ray films;right ventricular hypertrophy with a right axis deviation of incomplete right bundle branch block on the electrocardiogram;diameter of ASD over 1.5cm in ultrasonic cardiogram. [更多还原