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目的探讨小儿室间隔缺损（ＶＳＤ）伴肺动脉高压（ＰＨ）的手术时机和方法，进一步提高其手术疗效。方法回顾性总结分析５２例ＶＳＤ合并ＰＨ的外科治疗经验。平均年龄６．５±３．７岁，体重１６．１±５．８ｋｇ。采用中低温体外循环技术，其中经右房切口修补ＶＳＤ３２例，经肺动脉切口１７例，经右室切口３例。应用Ｄａｃｒｏｎ补片修补缺损，术后常规用呼吸机辅助呼吸和应用血管扩张剂。结果治愈５０例，死亡２例。随访３个月至２年，远期效果满意。结论小儿ＶＳＤ伴ＰＨ应尽早手术为宜，加强围术期的心肌保护，早期合理使用血管扩张剂是降低术后并发症和病死率的重要措施。
Objective To explore the operation timing and method of pediatric ventricular septal defect (VSD) complicated with pulmonary hypertension (PH) to further improve its curative effect. Methods Retrospective analysis of 52 cases of VSD combined PH surgical treatment experience. The average age of 6.5 ± 3.7 years old, weight 16.1 ± 5.8kg. The use of low-temperature cardiopulmonary bypass technology, including the right atrioventricular repair VSD32 cases, 17 cases of pulmonary artery incision, the right ventricle incision in 3 cases. The application of Dacron patch defect repair, postoperative ventilator-assisted breathing and the application of vasodilators. Results of 50 cases were cured, 2 died. Follow-up 3 months to 2 years, the long-term results are satisfactory. Conclusions Pediatric VSD with PH should be treated as soon as possible to enhance perioperative myocardial protection. Early rational use of vasodilators is an important measure to reduce postoperative complications and mortality.