[成人部分鼻中隔缺损的手术治疗结果[作者简介]。

W Schlick, P Pils, F Unger, P Schmid, W Mohl, M Frey, E Domanig, J Navrátil
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引用次数: 0

摘要

59例成人手术后鼻中隔缺损患者中55例术后复查。术后平均时间间隔为43.8个月。两名患者在手术后立即死亡;没有晚期死亡。大多数重新检查的受试者没有症状,没有一例充血性心力衰竭。术后症状的持续随着手术时年龄的增加而增加,但仅持续到生命的第四个十年。对26例进行了血流动力学检查。平均肺动脉压在静息和轻微负荷时正常。5例患者有中度肺动脉高压。8例患者肺血管阻力轻微增加,1例患者肺血管阻力中度增加。约25%的病例胸片显示心脏增大,超过50%的病例肺血管增强。术后心律失常并不比术前更频繁。然而,手术后右心轴偏移和右心室肥厚的心电图征象明显减少。肺功能研究显示肺活量和最大呼吸量略有下降。这些结果与文献中所述的接受医学治疗的患者组相比是有利的。结论是,即使在成年后期,房间隔缺损作为一种规则是手术的指征。
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[Results of operative treatment of artial septal defect in the adult (author's transl)].

55 of 59 patients with artial septal defect, who had been operated in adult age, were examined postoperatively. The mean time interval from the operation was 43,8 months. Two patients had died immediately after the operation; there were no late deaths. The majority of the reexamined subjects was free of symptoms, in no case was there congestive heart failure. Persistence of postoperative symptoms increased with increasing age at the time of operation, but only up to the fourth decade of life. In 26 cases hemodynamics were examined. Mean pulmonary arterial pressure was normal at rest and during a slight ergometric load. In 5 patients there was moderate pulmonary hypertension. In 8 subjects there was minimal, in one patient moderate increase of pulmonary vascular resistance. Heartsize in chest roentgenogramm was increased in about 25% of cases, in more than 50% the pulmonary vessels were accentuated. Irregularities of cardiac rhythm were not more frequent postoperatively, than they had been prior to surgery. However, surgery was followed by a marked decrease of right axis deviation and of EKG signs of right ventricular hypertrophy. Pulmonary function studies revealed a slight decrease of vital capacity and of maximal breathing capacity. These results are favourable compaired to medically treated groups of patients as described in the literature. It is concluded, that even in later adult age the atrial septal defect as a rule is an indication for surgery.

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