心疾患を伴う新生児主要外科疾患の治療成績の検討

概要

論文の詳細を見る
In a retrospective survey of 627 neonates with major pediatric surgical disorders treated during the last 15 years, cardiovascular malformations (CVMs) were present in 80 patients. Association of CVM was highest in patients with esophageal atresia (37.5%) followed by omphalocele (27.5%) and congenital duodenal atresia (19.2%). Of various CVMs, those characterized by increased pulmonary blood flow such as VSD, PDA, ECD, and CoA・IAA syndrome were the commonest (63.8%) of all. Severelity of the associated CVM was the most significant determinant of patient's prognosis and it was considered as main cause of death in 52% and was judged indirectly responsible for patient's deteriolation in 30% of the cases. Mortality (including operative, hospital and late death earlier than 6 months following initial operation) in patients with associated CVM was 56% in contrast to 6.7% for patients without CVM. It has decreased to 38% during the recent 5 years in contrast to 65% for the preceding 10 years and this decrease was most striking in patients with CVM characterized by increased pulmonary blood flow. It is concluded that early recognition, early noninvasive diagnosis and early surgical intervention when indicated of CVM are essential for the better outcome in the management of patients with associated CVM.
日本小児外科学会の論文
1987-12-20