Hung L C, Mohan A J, Soo T L, Ng H P
Institut Pediatrik, Hospital Kuala Lumpur, 50586 Kuala Lumpur.
Med J Malaysia. 2000 Dec;55(4):424-32.
This prospective, descriptive study was carried out to determine the pattern and the type of congenital heart disease seen in the Paediatric Departments in 4 government hospitals. The accessibility of surgical or transcatheter interventional treatment was also assessed. Consecutive new patients seen for suspected congenital heart disease from 1/1/95 till 31/12/95 (Group I) were registered. Records of patients seen from 1/1/95 to 31/8/95 (Group Ia) were reviewed 6 months after presentation to determine the nature of treatment received. Group II were cardiac patients who were first seen prior to the year 1995 and had undergone cardiac surgery or transcatheter interventional procedures in 1995. Of the 375 patients registered in the 4 hospitals, 250 were new patients and 125 were patients first seen prior to 1995 and had surgery or transcatheter interventional procedures in 1995. Of the 250 new patients, 83.2% had acyanotic cardiac lesions and 16.8% had cyanotic lesions. Ventricular septal defect was the commonest lesion, constituting 37.2%, followed by patent arterial duct (18.8%) and atrial septal defects (9.6%). At 6 month review, access to close-heart surgery or transcatheter interventional treatment were readily available. However, for patients with ventricular septal defects, 42.1% who required closure were still waiting for surgery 6 months after presentation. Of the 4 patients with Fallot's Tetralogy who required surgery, 2 had modified Blalock-Taussig shunt and 2 were awaiting surgery. In 1995, a total of 204 cardiac procedures were performed, there were 114 (55.9%) open heart procedures, 50 (24.5%) surgical ligation of the arterial duct, 28 (13.7%) modified Blalock-Taussig shunts, 11 (5.4%) transcatheter duct occlusion and 1 (0.5%) balloon valvuloplasty. The mean age of Fallot's Tetralogy repair was 6.4 years. No corrective surgery was performed for patients with complex cardiac lesions from the 4 hospitals in 1995. In conclusion, the pattern of congenital heart disease was similar to that seen world wide. Except for patent arterial duct, access to surgical treatment was inadequate.
本前瞻性描述性研究旨在确定4家政府医院儿科所诊治的先天性心脏病的类型和模式。同时还评估了手术或经导管介入治疗的可及性。对1995年1月1日至12月31日期间因疑似先天性心脏病就诊的连续新患者（第一组）进行了登记。对1995年1月1日至8月31日期间就诊的患者（第一a组）的记录在就诊6个月后进行了回顾，以确定所接受的治疗性质。第二组是1995年之前首次就诊并在1995年接受心脏手术或经导管介入治疗的心脏病患者。在这4家医院登记的375例患者中，250例为新患者，125例是1995年之前首次就诊并在1995年接受手术或经导管介入治疗的患者。在250例新患者中，83.2%患有非青紫型心脏病变，16.8%患有青紫型病变。室间隔缺损是最常见的病变，占37.2%，其次是动脉导管未闭（18.8%）和房间隔缺损（9.6%）。在6个月的复查中，心脏直视手术或经导管介入治疗很容易获得。然而，对于需要闭合室间隔缺损的患者来说，42.1%的患者在就诊6个月后仍在等待手术。在需要手术的4例法洛四联症患者中，2例进行了改良布莱洛克-陶西格分流术，2例在等待手术。1995年共进行了204例心脏手术，其中114例（55.9%）为心脏直视手术，50例（24.5%）为动脉导管手术结扎，28例（13.7%）为改良布莱洛克-陶西格分流术，11例（5.4%）为经导管动脉导管封堵术，1例（0.5%）为球囊瓣膜成形术。法洛四联症修复手术的平均年龄为6.4岁。1995年，这4家医院没有对患有复杂心脏病变的患者进行矫正手术。总之，先天性心脏病的类型与全球所见相似。除动脉导管未闭外，手术治疗的可及性不足。
