摘要
目的总结先天性心脏病法洛四联症的外科治疗经验。方法回顾性分析2004年1月至2012年8月385例法洛四联症根治手术患者的临床资料，男性231例，女性154例，年龄6个月至43岁，平均（4．31±1．62）岁，体重6．0-68．0（16．32±6．23）kg，血红蛋白70-240（17．25±3．12）g／L，均在气管插管、全麻、低温、体外循环下行法四根治术。结果手术早期死亡12例，死亡率3．12％，以低心排血量综合征和呼吸窘迫综合征最常见。主要手术并发症：低心排血量综合征24例、呼吸衰竭12例、肾功能衰竭2例、肺部感染24例、二次开胸止血6例、胸腔积液13例、心律失常5例。随访晚期无死亡患者。结论根治手术是法洛四联症的主要治疗方法。精准的术前解剖诊断，适宜的手术时机、手术指征。术中满意的右心室流出道疏通，严密完全的缺损修补，准确及时的ICU处理，是提高治愈率，减少并发症的关键。
Objective To summarize the surgical therapy experience of congenital heart disease, fallot＇s tetrad. Methods Retrospectively analyzed the clinic data of 385 cases of radical correction of fallots tetrad from January 2002 to August 2012, among of them, male 231 cases, female 154 cases, aged from 6-month-old to 43 years old （average 1.62±4.31 ）years old, weight 6.0-68 （average 6.23±16.32）kg, hemoglobin 70-240（average 3.12±17.25）/L. All oerations were completed throuzh tracheal intubation, eneral anaesthesia, hwoothermy, ex-tracorporeal circulation. Results Postoperatively, earlier death 12 cases, accounting for 3.12%, the main reasons were respectively low cardiac output syndrome and respiratory distress syndrome. Principal operative complication included low cardiac output syndrome 24 cases, respiratory failure 12 cases, renal failure 2 cases, pulmonary in- fection 24 cases, secondly opening chest to stop bleeding 6 cases, pleural effussion 13 cases, cardiac dysrhythmia 5 cases. In advanced stage, no death in following-up patients. Conclusion Radical correction of tetralogy of Fal- lot is principal operation for curing fallot＇s tetrad, preoperatively exact anatomy-diagnose, eligible operation opportunity and operation indic, satisfactory right ventricular outflow tract deoppilation, perfect ventrieular septal defect repair, timely and accurate intensive care unit treatment, all are critical to boost healing rate and reduce complications. Postoperative long-term result is good.
出处
《中国心血管病研究》
CAS
2013年第4期284-287,共4页
Chinese Journal of Cardiovascular Research
关键词
法洛四联症
心脏外科手术
Tetralogy of Fallot
Cardiac surgery operation
