法洛四联症根治联合体肺侧枝栓塞术与单纯根治术的短期疗效分析

目的探讨法洛四联症患者行一期根治联合体肺侧枝栓塞术与单纯根治术的短期临床疗效。方法回顾性分析郑州大学第一附属医院心血管外科2008年1月至2013年6月收治58例法洛四联症患者的临床资料,其中男36例、女22例,施行一期根治联合体肺侧枝栓塞术22例(A组,男12例、女10例),施行单纯一期根治术36例(B组,男24例、女12例),A组年龄(24.91±6.77)岁,B组年龄(22.42±5.06)岁。比较两组主动脉阻断时间、住ICU时间、术后住院时间、术后7 d及3个月左心室射血分数(LVEF)。结果全组无死亡,A组与B组术前性别、年龄、McGoon比值、血红蛋白(Hb)含量差异无统计学意义(均P>0.05);A组较B组主动脉阻断时间(43.87±13.02)min vs.(53.60±11.69)min,P<0.05]、住ICU时间(26.09±4.84)h vs.(28.87±4.38)h,P<0.05]和住院时间(12.32±1.81)d vs.(13.67±2.14)d,P<0.05]均较短,A组术后7 d LVEF高于B组(56.64%±8.19%vs.52.58%±5.62%,P<0.05),A、B组术后3个月LVEF差异无统计学意义(58.50%±8.78%vs.55.42%±6.18%,P>0.05)。结论法洛四联症一期根治联合体肺侧枝栓塞术与单纯根治术相比,主动脉阻断时间明显缩短,术后心功能恢复较快、较好。

Comparison of Short-term Outcomes of Radical Correction of Tetralogy of Fallot with or without Transcatheter Embolization of Major Aortopulmonary Collaterals

Objective To compare short-term outcomes of radical correction of tetralogy of Fallot （TOF） with or without transcatheter embolization of major aortopulmonary collaterals （APC）. Methods Clinical data of 58 TOF pa- tients undergoing radical correction from January 2008 to June 2013 in the Department of Cardiovascular Surgery, First Affiliated Hospital of Zhengzhou University were retrospectively analyzed. There were 36 male and 22 female patients. Among them, 22 patients （Group A, 12 males and 10 females） received radical TOF correction combined with transcathe- ter embolization of major APC, and 36 patients （Group B, 24 males and 12 females） received radical TOF correction alone. Average age of group A was （24.91 ± 6.77） years and that of group B was （22.42 ± 5.06） years. Aortic cross-clamping time, ICU stay, postoperative hospital stay, left ventricular ejection fraction （LVEF） 7 days and 3 months after the opera- tion were compared between the 2 groups. Results There was no in-hospital death. There was no statistical difference in sex, age, preoperative McGoon ratio or hemoglobin （Hb） levels between the 2 groups （P 〉 0.05 ）. Aortic cross-clamping time （43.87±_ 13.02） minutes vs. （53.60± 11.69） minutes, P 〈 0.05 ], ICU stay （26.09±4.84） hours vs. （28.87±4.38） hours, P 〈 0.05 ] and postoperative hospital stay （ 12.32 ± 1.81 ） days vs. （ 13.67 ± 2.14 ） days, P 〈 0.05 ] of group A were significantly shorter than those of group B. LVEF 7 days after the operation of group A was significantly higher than that of group B （56.64%_ 8.19% vs. 52.58%±5.62%, P 〈 0.05 ）, and there was no statistical difference in LVEF 3 months after the operation between the 2 groups （58.50%±8.78% vs. 55.42%±6.18%, P 〉 0.05）. Conclusion For surgical treatment of TOF, compared with radical correction alone, radical correction combined with transcatheter embolization of major APC can significantly shorten aortic cross-clamping time and improve post