摘要
目的总结125例3岁以下婴幼儿法洛四联症（tetralogy of Fallot，TOF）患者手术方法；探讨手术时机、危险因素及围术期处理。方法对125例TOF患者行根治术，其中单纯右心室流出道漏斗部狭窄37例，漏斗部及肺动脉瓣狭窄14例，主肺动脉及左右肺动脉狭窄74例。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5例，死亡率为4．0％。死亡原因：严重低心排血量综合征3例，灌注肺1例，心包感染1例。术后肺部并发症9例，均经治疗后康复。结论TOF根治术患者的年龄宜减少，术中操作要精细。手术成功的关键是有效预防和控制低心排及肺部并发症。
Objective To sum up the therapeutic results of 125 cases of tetralogy of Fallot（ TOF）, and explore the optimal time and risk factors of opration,as well as perioperative management. Methods One hundred and twenty - five consecutive cases of TOF underwent corrective surgery. There were simple stenosis of infundibular portion in right ventricular outflow tract in 37 cases, stenosis of infundibulum and pulmonary valve in 14 cases, main pulmonary trunk and left/right pulmonary arteries stenosis in 74 cases. Autologouspericardial conduit,or with waived were used for right ventricular outflow tract and right ventriculo - pulmonary artery connection. Other anomalies were corrected. Results The surgicalmortality was 4.0% o The cause of death were serious low cardiac output syndrome（3 patients） ,respiratory function failure（ 1 patient）, Pericadial infection（ 1 patient）. Conclusion It is necessary to proform corrective opration on younger TOF patients. Effetive prophylaxis and control of low cardiac output syndrome and pulmonary complication is a useful strategy.
关键词
婴幼儿
法洛四联症
外科治疗
Infant Tetralogy of Fallot Surgical treatment
