Krull F, Latta K, Hoyer P F, Ziemer G, Kallfelz H C
Division of Pediatric Nephrology, Hannover Medical School, Germany.
Pediatr Cardiol. 1994 Jul-Aug;15(4):159-62. doi: 10.1007/BF00800668.
Cerebral ultrasonography was performed in 66 infants before and after open heart surgery in order to study the incidence of cerebral complications. The underlying cardiac malformations were ventricular septal defect (n = 28), transposition of the great arteries (n = 11), tetralogy of Fallot (n = 8), complete atrioventricular septal defect (n = 5), total anomalous pulmonary venous drainage (n = 3), truncus arteriosus communis (n = 2), and complex cardiac malformations (n = 9). In 60 of the 66 infants ultrasonography of the brain preoperatively was normal, 3 had minor structural abnormalities, and 3 had ventriculomegaly of various degrees. Postoperatively, 46 infants had a normal brain ultrasound scan; 6 had slight structural abnormalities; and 5 had slight symmetric or asymmetric widening of the ventricles. Five infants showed severe ventriculomegaly with cerebral atrophy, and in 4 patients there was intracerebral hemorrhage, associated in 2 cases with severe ventriculomegaly. On repeat examinations it was found that up to 4 weeks after the operation an initially normal cerebral ultrasound scan could convert to a pathologic one. Most of those children who showed significant deterioration on the cerebral ultrasound scan suffered from complex cardiac malformations or had severe problems during the postoperative period.
对66例婴儿在心脏直视手术前后进行了脑部超声检查，以研究脑部并发症的发生率。潜在的心脏畸形包括室间隔缺损（n = 28）、大动脉转位（n = 11）、法洛四联症（n = 8）、完全性房室间隔缺损（n = 5）、完全性肺静脉异位引流（n = 3）、共同动脉干（n = 2）和复杂心脏畸形（n = 9）。66例婴儿中，60例术前脑部超声检查正常，3例有轻微结构异常，3例有不同程度的脑室扩大。术后，46例婴儿脑部超声扫描正常；6例有轻微结构异常；5例脑室有轻微对称性或不对称性增宽。5例婴儿出现严重脑室扩大伴脑萎缩，4例有脑出血，其中2例伴有严重脑室扩大。复查发现，术后长达4周时，最初正常的脑部超声扫描可能转变为病理性扫描。脑部超声扫描显示明显恶化的大多数儿童患有复杂心脏畸形或术后出现严重问题。
