Kashima I, Aeba R, Katougi T, Mitsumaru A, Tsutsumi K, Iino Y, Koizumi K, Enoki T, Kawada S
Department of Surgery, Keio University School of Medicine, Tokyo, Japan.
Kyobu Geka. 2000 Oct;53(11):946-9.
In this study, we investigated perioperative and long-term prognosis and the risk of major complications after repair of ventricular septal defect in 48 patients with Down's syndrome who underwent ventricular septal defect repair between May 1980 to August 1999 were compared with those in 48 patients with normal chromosomes matched for age and time period. Pp/Ps were significantly lower after the operation in both groups; however perioperative and postoperative Pp/Ps of Down's syndrome group were significantly higher than that those of control group. The duration of intubation was significantly longer in the Down's syndrome group and the case-control study revealed that the risk of long intubation (> or = 7 days) was significantly higher in the Down's syndrome group, but the incidence of PH crisis did not differ between the 2 groups. The main reasons of prolonged intubation period were respiratory complications such as pneumonia or atelectasis. In Down's syndrome group, a 5 months old boy died of heart failure on the 5th postoperative day. All other patients were survived through a mean follow-up period of 122.4 months (the follow-up rate was 95.8%). In conclusion, the perioperative and long-term prognosis after ventricular septal defect repair in patients with Down's syndrome were similar to those in patients with normal chromosome.
在本研究中，我们调查了1980年5月至1999年8月期间接受室间隔缺损修复术的48例唐氏综合征患者的围手术期和长期预后以及主要并发症风险，并将其与48例年龄和时间段匹配的染色体正常患者进行比较。两组术后Pp/Ps均显著降低；然而，唐氏综合征组围手术期和术后的Pp/Ps显著高于对照组。唐氏综合征组的插管时间显著更长，病例对照研究显示，唐氏综合征组长时间插管（≥7天）的风险显著更高，但两组之间PH危象的发生率没有差异。插管时间延长的主要原因是肺炎或肺不张等呼吸系统并发症。在唐氏综合征组中，一名5个月大的男孩术后第5天死于心力衰竭。所有其他患者均存活，平均随访期为122.4个月（随访率为95.8%）。总之，唐氏综合征患者室间隔缺损修复术后的围手术期和长期预后与染色体正常患者相似。
