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先天性心脏畸形的外科治疗。适应证与手术处理(作者译)

[Surgical treatment of congenital heart malformations. Indications and surgical management (author's transl)].

作者信息

Dalichau H, Hügel W

出版信息

Monatsschr Kinderheilkd (1902). 1979 Apr;127(4):179-91.

PMID:449875
Abstract

Congenital malformations of the heart have to be expected in approximately 0,8% of all newborns. The majority of them needs surgical treatment and can be corrected anatomically with a low operative risk (atrial and ventricular septal defects, patent ductus arteriosus, coarctation, valvular aortic and pulmonary stenosis etc.). Surgical repair of complex anomalies includes either palliative or functionally corrective procedures and has a much higher operative and early postoperative mortality (transposition of the great arteries, tetralogy of Fallot, tricuspid atresia etc.). Surgery becomes urgent in babies suffering from congestive heart failure and/or progressive severe hypoxia during the first months of life. Early total surgical repair or primary palliation and two-stage correction depends on the kind of anomaly and has to be selected individually. Hemodynamical classification, general distribution and surgical considerations of the most common congenital malformations of the heart are described.

摘要

在所有新生儿中,先天性心脏畸形的发生率约为0.8%。其中大多数需要手术治疗,并且可以通过解剖矫正,手术风险较低(房间隔和室间隔缺损、动脉导管未闭、主动脉缩窄、主动脉瓣和肺动脉瓣狭窄等)。复杂畸形的手术修复包括姑息性或功能性矫正手术,手术和术后早期死亡率要高得多(大动脉转位、法洛四联症、三尖瓣闭锁等)。对于在生命最初几个月出现充血性心力衰竭和/或进行性严重缺氧的婴儿,手术变得十分紧急。早期完全手术修复或一期姑息治疗以及二期矫正取决于畸形的类型,必须个体化选择。本文描述了最常见先天性心脏畸形的血流动力学分类、总体分布及手术考量。

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