对伴或不伴主动脉弓梗阻的室间隔缺损行早期修复的神经发育预后

作     者：Kaltman J.R. Jarvik G.P. Bernbaum J. 刘宇 

作者机构：Division of CardiologyChildren's Hospital of Philadelphia34th and Civic Center BlvdPhiladelphiaPA 19104United States.Dr 

出 版 物：《世界核心医学期刊文摘（心脏病学分册）》 (Digest of the World Core Medical Journals(Cardiology))

年 卷 期：2006年第2卷第9期

页      面：57-57页

学科分类：1002[医学-临床医学] 100202[医学-儿科学] 10[医学] 

主　　题：单纯室间隔缺损 神经发育障碍 主动脉弓 梗阻 早期修复 婴幼儿发育量表 运动发育指数 患儿心理 

摘      要：Objectives: Cross-sectional studies of intermediate-term survivors of infant cardiac surgery have revealed a high frequency of neurodevelopmental disabiliti es. Few data exist regarding neurodevelopmental outcome of infants undergoing su rgical intervention for a ventricular septal defect. The purpose of this study w as to evaluate the neurodevelopmental outcome at 1 year of age of children who h ad surgical repair in infancy of a ventricular septal defect or a ventricular se ptal defect with aortic arch obstruction. Methods: Children who underwent repair of a ventricular septal defect or single-stage repair of a ventricular septal defect with aortic arch obstruction at less than 6 months of age were assessed a t 1 year of age by using the Bayley Scales of Infant Development II, which yield s the Mental Development Index and the Psychomotor Development Index, both with an expected mean of 100±15. Results: At 1 year, 55 patients(ventricular septal defect alone=36; ventricular septal defect with aortic arch obstruction=19) retu rned for evaluation. The mean Mental Development Index was 92.6±11.7, with 3(5 %) patients scoring 70 or less. The mean Psychomotor Development Index was 86.1 ±16.4, with 10(18%) patients scoring 70 or less. Patients with a suspected or confirmed genetic syndrome had both a lower Mental Development Index score(P=.01 1) and a lower Psychomotor Development Index score(P=.001). Mental Development I ndex and Psychomotor Development Index were independent of anatomic(specifically aortic arch obstruction) and intraoperative factors(specifically deep hypotherm ic circulatory arrest). Conclusions: Neurodevelopmental outcome at 1 year of age was within the normal limits for most patients who underwent repair of a ventri cular septal defect or a ventricular septal defect with aortic arch obstruction during infancy.