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目的：从病理学角度分析婴幼儿先天性心脏病术后死亡原因。方法：收集３岁以内先天性心脏病尸检病例５２例，核查心脏畸形、矫治情况和组织学改变，分析其死因。结果：手术病死率４．６８％，尸检率３０．０６％，诊断符合率８４．６２％。主要死因为：心肌急性缺血性损伤、手术创伤或误伤各９例、原狭窄解除不彻底或新建通道不畅８例、肺出血、透明膜形成６例、支气管痰堵４例、肺水肿３例、残留畸形、肺炎、肺发育不良各２例、肺动脉高压、肾功能衰竭各１例。５例未见致死性病理形态改变。结论：加强婴幼儿心脏手术中的心肺保护、改进外科技术、注意术后呼吸监护可望进一步提高手术生存率。
Objective: To analyze the causes of postoperative death of congenital heart disease in infants and young children from the pathological point of view. Methods: Fifty-two cases of congenital heart disease autopsy within 3 years of age were collected. Cardiac deformity, correction and histological changes were checked and their causes of death were analyzed. Results: The operative mortality rate was 4.68% and the autopsy rate was 30.06%. The diagnostic coincidence rate was 84.62%. The main causes of death were myocardial acute ischemic injury, traumatic injury or accidental injury in 9 cases. The original stenosis was not completely relieved or the new pathway was poor, 8 cases of pulmonary hemorrhage, 6 cases of transparent membrane formation, 4 cases of bronchial phlegm blockage, 4 cases of pulmonary edema Cases, residual deformity, pneumonia, lung dysplasia in 2 cases, pulmonary hypertension, renal failure in 1 case. No fatal pathological changes in 5 cases. CONCLUSIONS: Cardiopulmonary protection in infants and young children with cardiac surgery is improved, surgical techniques are improved, and postoperative respiratory monitoring is expected to further improve the survival rate.