目的总结成人型法洛四联征(TOF)的临床特点，分析其围术期转归，指导预见性治疗。方法选择成人和儿童型TOF各56例，对围术期各项指标进行对比，分析成人TOF特点。结果成人TOF缺氧发作次数与儿童比较无差别，而紫绀程度重、咯血事件多，体肺侧支血管数目较儿童明显多。手术死亡率无差异，而术后残余漏多，呼吸机支持时间显著长于儿童型。结论成人型TOF手术指征与儿童相同，因侧支循环多及右室心肌纤维化，术后容易出现右心功能衰竭、低心排、灌注肺、出血等，对其体肺侧支封堵或结扎，加强监护，针对性进行处理。手术成功率满意。%Objective To summerize the Clinical characteristic of Tetralogy of Fallot(TOF)in adults,and analyze the Perioperative outcome, direct the predictive therapy.Methods To compare the various index between 56 cases of child and 56 cases of adult with TOF and study the Clinical characteristic of TOF in adult.Results There were no distinction between two groups in cyanotic spells.The degree of cyanosis in adult was severer than that in child. Incident of hemoptysis in adult was more, the number of aortopulmonary collateral arteries was more, There were no distinction in mortility after surgery.residual shunt were more, the time of mechanical ventilation in adult was significantly longer than that in child.Conclusion Indications for surgery treatment with TOF were same between adult and child.Incidents of complication of right heart failure、low cardiac output、perfusion-induced lung injury and bleeding in adult were significant higher than those in child because of aortopulmonary collateral arteries and right ventriclur myocardial fibrosis after operation. aortopulmonary collateral arteries shoud be treated by interventional therapy or ligation,closely observation and Individualized treatment are important to improve surgical outcome.
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