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[先天性心脏缺陷患儿术后残余杂音]

[Residual postoperative murmurs in children with congenital heart defects].

作者信息

Vucinić D, Malcić I, Jelić I

机构信息

Medicinskom centru Nasice, Klinika za djecje bolesti, KBC Rebro, Zabreb.

出版信息

Lijec Vjesn. 1992 May-Aug;114(5-8):100-4.

PMID:1343036
Abstract

Fifty-four children without postoperative complications were admitted to the Department of Pediatrics, University Hospital Rebro, following a complete surgical correction of ventricular septal defect (VSD), atrial septal defect - secundum type (ASD II) and patent ductus arteriosus (PDA) in the period from June, 1989, to February, 1991. Twenty-two patients were treated surgically for VSD, 17 for ASD II and 15 for PDA. There were 23 male and 31 female children. In the early postoperative period, 57% of all the examinees had a murmur with the innocent or functional characteristics. The murmur was significantly more frequent among children with VSD than among children of other groups (ASD II, PDA). Sex, age and hematocrit did not influence this difference. There were 8 anemic children (3 with operated VSD, 4 with ASD II, and 1 with PDA). From this, it may be concluded that anemia also did not cause this difference. However, anemic children represented 50% of the examinees with a murmur among the operated for ASD II and 33% among those treated surgically for PDA. When these anemic children were eliminated, the others operated on for ASD II and PDA probably had the innocent murmurs, since the proportion of examinees with a murmur fits into the incidence of innocent murmurs in the population. The children operated for VSD have had a greater proportion of examinees with a murmur, and most likely, some of these murmurs do not belong to a group of innocent or functional murmurs. Their cause is unknown, as yet (probably, small organic lesion).(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

1989年6月至1991年2月期间,54名无术后并发症的儿童入住雷布罗大学医院儿科,他们均接受了室间隔缺损(VSD)、继发孔型房间隔缺损(ASD II)和动脉导管未闭(PDA)的完全手术矫正。22例患者接受了VSD手术治疗,17例接受了ASD II手术治疗,15例接受了PDA手术治疗。其中有23名男童和31名女童。术后早期,所有受检者中有57%出现具有无害或功能性特征的杂音。VSD患儿中出现杂音的频率明显高于其他组(ASD II、PDA)的患儿。性别、年龄和血细胞比容并未影响这一差异。有8名贫血儿童(3名接受VSD手术,4名接受ASD II手术,1名接受PDA手术)。由此可以得出结论,贫血也未导致这一差异。然而,贫血儿童在接受ASD II手术的受检者中占出现杂音者的50%,在接受PDA手术治疗的受检者中占33%。排除这些贫血儿童后,接受ASD II和PDA手术的其他儿童可能出现的是无害杂音,因为出现杂音的受检者比例符合人群中无害杂音的发生率。接受VSD手术的儿童中出现杂音的受检者比例更高,而且很可能其中一些杂音不属于无害或功能性杂音类别。其原因目前尚不清楚(可能是微小器质性病变)。(摘要截断于250字)

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