婴幼儿法洛四联征根治术77例治疗分析

摘要

Objective:To summarize the experience of tetralogy of Fallot radical operation in infants,improve surgical technique and reduce mortality. Methods:The clinical data of 77 cases treated with tetralogy of Fallot radical operation were retrospectively analyzed. Pure right ventricular outflow tract patch in 15 cases and pulmonary valve ring patch in 62 cases were implentmented through median incision under the condition of middle and low temperature/profound hypothermia low flow. Results:One case died after the operation, which was mainly caused by low cardiac output syndrome, other cases with ventilator-associated pneumonia, arrhythmia, cardiac tamponade and pleural effusions were cured. None died during the period of following-up for 3 to 24 months. Conclusions:The effects of radical operation in the treatment of tetralogy of Fallot in infants are good. Early correcting cardiac malformation and strengthening postoperative management can effectively reduce the mortality rate of infants.%目的：总结婴幼儿法洛四联征根治术的治疗经验，提高手术技巧，降低死亡率。方法：对行法洛四联征根治术的77例患儿临床资料进行回顾分析。手术方法采用正中切口，中低温/深低温低流量，单纯右心室流出道补片15例，跨肺动脉瓣环补片62例。结果：手术死亡1例，主要死亡原因是低心排综合征。其他并发症有呼吸机相关性肺炎、心律失常、心包填塞、胸腔积液等，通过治疗痊愈。随访3~24个月，无一例死亡。结论：法洛四联征在婴幼儿期行根治术，手术效果满意。早期彻底矫治心脏畸形，加强术后管理，可以有效降低患儿死亡率。