婴儿法洛四联症根治术82例临床分析

目的总结近3年完成的82例婴儿法洛四联症(TOF)患者手术方法,探讨手术时机、危险因素及围手术期处理。方法自2002年6月～2005年10月共对82例婴儿TOF患者行根治术,分别予以自体心包或带心包做瓣的自体心包扩大右室流出道和或肺动脉;合并畸形作相应处理。结果全组手术死亡3例,病死率为3.7%。死亡原因为严重低心排出量综合征2例,灌注肺1例。术后肺部并发症5例,低心排出量综合征3例,急性肾功能衰竭2例,均经治疗后康复。结论TOF患者在婴儿期行根治术可以取得满意的临床效果;手术成功的关键是完全矫正心内畸形,有效预防和控制低心排出量综合征以及肺部并发症。

Clinical analysis of total repair in 82 infants with tetralogy of Fallot

Objective To sum up the therapeutic results of 82 cases of tetralogy of Fallot (TOF) in infants,and investigate the optimal time and risk factors of operation,as well as perioperative management.Methods Between Jun.2002 and Oct.2005,82 cases of TOF (male 52,female 30) underwent corrective surgery.Autologouspericardial conduit or with valve were used for right ventricular outflow tract and right ventriculo-pulmonary artery connection.Other anomalities were corrected.Results The surgical mortality was 3.7%.The cause of death were serious low cardiac output syndrome (2 patients),respiratory function failure (1 patient).Conclusion The results of total repair for TOF in infants are satisfactory. The deformity is satisfied put right,effective prophylaxis and control of low cardiac output syndrome and pulmonary complication are the key factors to assure surgical outcome.