Retrospective Study Of Prognosis And Outcome Of Children With Ventricular Septal Defect

Objective：A retrospective study of450cases of children with VSD,explore the related factors in children with VSD natural healingprocess, to understand the prognosis and outcome of children withVSD better.Methods：The study group consisted of450cases from January2005to March2013,all of them were diagnosised VSD by CDE on0-6monthsafter birth in our hospital,and the investigation period for atleast1year,up to4years.According to the final survey resultswhich are the process of natural development of the VSD,the childrendivided by healing groups and healed group,the healing group is thestudy group,the healeds’is the control group.68cases of childrenwith VSD was operated,can not be included in the VSD natural healingprocess,so excluding these cases when research the VSD relatedfactors by statistically analyzed.Statistical information isincluded in some patients the prognosis and outcome of children withVSD analysis.Between healing group and healed group of children0-6months using t-test to compared mean±standard deviation of thesefactors which are VSD diameter,AOD,MPA,LAD,RVD,LVEDD andrespiratory infections integration. Using the2test to compare the following factors,including:VSDassociated with other congenital heart disease (ASD,PDA, pH, etc.),complex CHD with VSD, PAVP,the situation of defect (pmVSD, MVSD,under dry roomseptal defect, mixed defect), membrane aneurysmformation,C/T,DS children with VSD,VSD combined hyperbili-rubinemia the first3months after the pregnant mother of parentsof children with smoking,alcohol abuse,taking drugs,exposure toradiation between two groups.T-test and2test,screening15factors which related the VSD natural Healing process and then applytwo classification Logistic stepwise regression analysis on15factors.Results：Children3years or less,VSD natural healing rate is87.35%,but the ratio decreased significantly after the age of three.The application independent samples t-test method of the relevantfactors mean±standard deviation (x±s)comparison between the twogroups,the results show:two groups of small VSD,the medium-sizedVSD, MPA, LAD, RVD, LVEDD,respiratory infections the integralcomparison group difference was statistically significant. The AOD,large VSD,IVST group comparison although the difference,but werenot statistically significant(p>0.05).Application of2test,comparison between the two groups on relevant factors,the resultsare as follows:the VSD merger PDA,complex CHD associated with VSD,PAVP <1.05m/s,PMVSD,MVSD,VSD with membranous neoplasia, VSDchildren C/T normal and VSD associated with anemia,the differencewas statistically significant(p<0.05).VSD with ASD, VSD combinedPH,dry type VSD the mixed defect,DS accompanied children withVSD,combined with hyperbilirubinemia,the parents of children withsmoking,alcohol consumption,exposure to radiation,taking drugwhen the first three months of the pregnant mother were notstatistically significant (p>0.05).The single factor analysis of15variables meaningful introduced the two Logistic regressionmodel,opt-in and removed the variable significance level of0.05and0.10,respectively,eventually filter out nine variables:PDA,complex CHD,PAVP,PMVSD,MVSD,small VSD,membrane aneurysm formation,C/T,infection points.Surgical or interventional treatment of68cases of children with VSD findings suggest that within6monthsafter one cases of children with residual shunt,respiratory tractinfection in2cases cured,21cases of arrhythmia in children6months after surgery only one case of atrioventricular block exists,the rest of the children returned to normal,the overall prognosisis good.Died in the course of the investigation of seven cases ofchildren with VSD,are complex CHD associated with VSD,the childrenearly stage there are more complications, recurrent infections,andfinally died of heart failure and respiratory failure. Conclusion：1.The prognosis and outcome will well,if patients withall or more characters which are include Small VSD, pmVSD,MVSD,membrane aneurysm formation,normal heart size and PAVP<1.05m/s,so these patients who heart function and growth well,cannot operatebut regulate monitoring CDE to school-age.2.If patients have allor more factors which are VSD with PDA,complex CHD associated withVSD,dry-type VSD,large VSD,DS children and serious respiratorytract infection,the prognosis and outcome will be poor,and patientsneed to give surgical treatment as soon as possible.3.the parentsof children with smoking,alcohol consumption,exposure to radiation,taking drug when the first three months of the pregnant mother werenot related with the VSD natural healing process.4.The findings ofthis article suggest that VSD surgery or interventional treatmentoverall prognosis is good.